General Information

Treatment of serious Gram-negative or polymicrobial infections, including mixed aerobic and anaerobic infections, where the use of other agents is not appropriate because of resistance, contraindications or adverse events

Broad spectrum agent with antipseudomonal activity. Used for severe infections including:

  • Hospital or ventilator acquired pneumonia
  • Intra-abdominal/hepatobiliary infections
  • Multi-drug resistant UTIs/Urosepsis
  • Febrile neutropenia
  • Polymicrobial skin and soft tissue infection


  • Poor CNS penetration, use alternative agent
  • Avoid for serious/invasive AmpC microorganisms (e.g. Citrobacter, Enterobacter infections), even if reported as susceptible
  • Periodically monitor electrolytes, serum creatinine, CBC for prolonged therapy
  • Allergy/rash (immediate or delayed)
  • Cytopenias- esp. thrombocytopenia and neutropenia
  • Eosinophilia
  • Interstitial nephritis
  • Abnormal liver enzymes

Increase levels of methotrexate

  • 2.84 mEq of sodium in each gram of piperacillin

Antimicrobial class: Ureidopenicillin with a beta-lactamase inhibitor

Pregnancy category: B

Average serum half life: 1 hour

Biliary penetration: Therapeutic

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Therapeutic