See below under General Info


General Information

Hospital Formulary Status Yes (parenteral inj)

In-Hospital Cost will be updated

PharmaCare Formulary Status No

Special Authority None

PharmaCare Coverage None

Outpatient Cost 2.25g powder for soln/inj - $10.94-12.03/vial 3.375g powder for soln/inj - $16.42-18.06/vial 4.5g powder for soln/inj - $21.89-24.08/vial

Broad spectrum agent with anti-pseudomonal activity.

Used for severe infections including:

  •  Pneumonia
  •  Intra-abdominal/hepatobiliary
  •  UTI
  •  Polymicrobial skin and soft tissue infection
  •  Febrile neutropenia

Acute liver injury (IV)

  • usually mild and self-limiting
  • involves cholestatic hepatitis and elevations in ALT, AST and alkaline phosphatase
  • sx: jaundice, fever, headache, nausea and skin rash
  • liver failure is rare

Hemolytic anemia (IV)

  • immune-mediated
  • characterized by positive non-gamma Coombs' test or subacute extravascular hemolysis with positive gamma Coombs' test
  • usually signs of hypersensitivity are absent

Neutropenia (IV)

  • sx: abrupt onset of fever, rash, and eosinophilia
  • associated with immune-mediated destruction of polymorphonuclear leukocytes

Thrombocytopenia (IV)

  • acute immune-mediated
  • usually platelet count normalizes within 2 weeks after discontinuation
  • platelet dysfunction may be caused by high doses

Allergic interstitial nephritis (IV)

  • sx: acute and often severe renal failure, with active urinary sediment (hematuria, proteinuria, and pyuria) but no red cell casts
  • usually signs of hypersensitivity are present (fever, peripheral eosinophilia, eosinophiluria and rash)
  • several cases of cross-sensitivity between beta-lactam antibiotics
  • concomitant use of piperacillin/tazobactam and vancomycin has been associated with AKI

Pulmonary infiltrate with eosinophilia (PIE) syndrome (IV)

  • sx: abrupt onset of fever, chills, dyspnea, pulmonary infiltrates and peripheral eosinophilia

CNS toxicity (IV)

  • sx: seizures, encephalopathy, change in LOC (somnolence, stupor, or coma), hyperreflexia and myoclonus
  • less epileptogenic than penicillin, due to ureido group

Allergic reaction (IV)

  • IgE-mediated
  • sx: pruritus, flushing, urticaria, angioedema, wheezing, laryngeal edema, hypotension, and/or anaphylaxis
  • sx usually appear within 4 hrs of administration but may begin within mins

Serum sickness (IV)

  • late allergic reaction
  • sx: fever, rash, adenopathy, arthritis and glomerulonephritis
  • associated with circulating immune complexes

Rash (IV)

  • includes morbilliform rash, erythema multiforme, SJS, exfoliative dermatitis, toxic epidermal necrolysis and vasculitis
  • sx: photosensitivity, skin lesions, mucosal membrane ulceration, erythema, scaling, palpable purpura and/or positive Nikolsky's sign

Note: EBV-related rash - not an allergy

  • morbilliform rash, occurring 48 hrs to weeks after initial amoxicillin exposure in patients with Epstein Barr Virus, does not appear to be a true drug allergy

Incr. levels of methotrexate

Antimicrobial class: Ureidopenicillin + Beta-Lactamase Inhibitor

Pregnancy category: B

Average serum half life: 1.0 hr

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Poor

Biliary penetration: Therapeutic