Piperacillin-Tazobactam

C difficile risk
Medium
Oral Bioavailability
N/A
Cost
$8-15/day

Dosing

CrCl < 20Standard dose 3.375 g IV q12h infused over 4 hours

Patients > 120 kg or organism with higher MIC 4.5 g IV q12h infused over 4 hours

Standard dose 3.375 g IV q12h infused over 4 hours

Patients > 120 kg or organism with higher MIC 4.5 g IV q12h infused over 4 hours

3.375 g IV q8h infused over 4 hours

Note Inpatient Billings Clinic utilizes extended infusion (4 hours) which maximizes drug exposure for time dependent beta-lactams

Standard dose 3.375 g IV q8h infused over 4 hours

Patients > 120 kg or organism with higher MIC 4.5 g IV q8h infused over 4 hours

Cystic Fibrosis 4.5 g IV q6h over 4 hours

Product build in Cerner is combination product - meaning piperacillin PLUS tazobactam component; 3 g piperacillin plus 0.375 g tazobactam = 3.375 g pip/tazo.

Please consider this when entering a dose in the computer. Recommend putting desired dose of piperacillin mg/kg in comments.Use 30 minute infusion for pediatric patients except CF patients 12 years of age and older

  • 300 mg/kg/day divided q6-8 hours of piperacillin component up

  • 337.5 mg/kg/day combination product in computer in divided doses up to 3.375 g IV q6h, may consider up to 4.5 g IV q6h for patients as risk with Pseudomonas aeruginosa

  • 400 mg/kg/day divided q6h of piperacillin component

  • 450 mg/kg/day in divided doses combination product in the computer up to 4.5 g IV q6h

General Information

Broad spectrum agent with anti-pseudomonal activity.

Used for severe infections with risk factors for more resistant organisms including:

  •  Pneumonia

  •  Intra-abdominal/hepatobiliary

  •  UTI

  •  Polymicrobial skin and soft tissue infection

  •  Febrile neutropenia

Long term: weekly CBC, CMP

  • Allergy/rash (immediate or delayed)

  • Cytopenias- esp. thrombocytopenia

  • Eosinophilia

  • Interstitial nephritis

  • Abnormal liver enzymes

Incr. levels of methotrexate

Tends to have higher GI toxicity with high doses in pediatric patients

Antimicrobial class: Ureidopenicillin with a beta-lactamase inhibitor

Pregnancy category: B

Average serum half life: 1 hour

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Poor

Biliary penetration: Therapeutic

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