INJPIP TZ 4.5

Indications

• Bacterial infections caused by susceptible organisms
• Pneumonia
• Intra-abdominal infections
• Skin and soft tissue infections
• Urinary tract infections
• Sepsis

Dosage

Children: Refer to the BNF for Children for appropriate dosing guidelines based on age, weight, and clinical condition.

Adults: Refer to the BNF for specific dosing recommendations based on the type and severity of infection, as well as patient-specific factors.

Mechanism of action

Piperacillin exerts its antibacterial effects by binding to specific penicillin-binding proteins (PBPs) located within the bacterial cell wall. This binding inhibits the third and final stage of bacterial cell wall synthesis, leading to cell lysis mediated by bacterial autolytic enzymes, such as autolysins. Additionally, Piperacillin may interfere with autolysin inhibitors, further promoting bacterial cell death.

Pharmacodynamics

As a beta-lactam antibiotic, Piperacillin displays bactericidal activity primarily through the inhibition of bacterial cell wall synthesis. It is effective against a range of both gram-positive and gram-negative aerobic and anaerobic bacteria. Piperacillin's stability against hydrolysis by various beta-lactamases, including penicillinases and extended-spectrum beta-lactamases, contributes to its clinical utility in treating infections caused by resistant organisms.

Pharmacokinetics

Piperacillin is generally administered parenterally, as it is not well absorbed from the gastrointestinal tract. It distributes well in body tissues and fluids, including the lungs, kidneys, and soft tissues. The drug is primarily excreted unchanged in the urine, and its half-life is typically around 1 hour, but this can vary based on renal function. Dose adjustments may be necessary in patients with renal impairment to avoid accumulation and toxicity.

Interactions

• piperacillin + neuromuscular blocking drugs, non-depolarising: Unknown (increases effects)
• piperacillin + suxamethonium: Unknown (increases effects)

Pregnancy

Piperacillin may be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Consultation with a healthcare professional is recommended.

Breast-feeding

Piperacillin is excreted in breast milk. Caution is advised when administering to nursing mothers.

Storage

Store at room temperature, away from light and moisture. Keep out of reach of children.

Formulations

• Injectable solution
• Powder for injection

Indications

• Complicated intra-abdominal infections
• Complicated skin and soft tissue infections
• Pneumonia
• Urinary tract infections
• Septicemia
• Infections caused by multidrug-resistant bacteria

Dosage

Adults: Refer to the BNF for specific dosing information based on the clinical situation and the combination product used.

Mechanism of action

Tazobactam inhibits bacterial beta-lactamase enzymes, which are responsible for the degradation of beta-lactam antibiotics. This irreversible inhibition is achieved through covalent binding to both plasmid-mediated and chromosome-mediated beta-lactamase enzymes. Tazobactam is particularly effective against the OHIO-1, SHV-1, and TEM groups of beta-lactamases, allowing beta-lactam antibiotics to remain active against organisms that would otherwise resist treatment.

Pharmacodynamics

Tazobactam enhances the effectiveness of beta-lactam antibiotics by inhibiting the action of beta-lactamase producing organisms. This inhibition allows the beta-lactam antibiotics to exert their antibacterial effects on a wider range of bacteria, including those that are typically resistant. The combination of tazobactam with other antibiotics can be critical in treating a variety of infections, including serious and life-threatening conditions.

Pharmacokinetics

Tazobactam is administered intravenously and is rapidly distributed in the body. It has a relatively short half-life, necessitating frequent dosing when used in combination with antibiotics. The pharmacokinetics of tazobactam are influenced by factors such as renal function, and adjustments may be required in patients with impaired kidney function. It is primarily eliminated via the kidneys, with both renal clearance and tubular secretion playing roles in its excretion.

Pregnancy

Tazobactam should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is not known whether tazobactam is excreted in human milk. Caution should be exercised when administering tazobactam to nursing mothers.

Storage

Store in a cool, dry place away from direct light. Do not freeze.

Formulations

• Tazobactam is available in combination formulations with piperacillin and ceftolozane.

Mechanism of action

By binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, Piperacillin inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins; it is possible that Piperacillin interferes with an autolysin inhibitor.

Pharmacodynamics

Piperacillin is a penicillin beta-lactam antibiotic used in the treatment of bacterial infections caused by susceptible, usually gram-positive, organisms. The name "penicillin" can either refer to several variants of penicillin available, or to the group of antibiotics derived from the penicillins. Piperacillin has <i>in vitro</i> activity against gram-positive and gram-negative aerobic and anaerobic bacteria. The bactericidal activity of Piperacillin results from the inhibition of cell wall synthesis and is mediated through Piperacillin binding to penicillin binding proteins (PBPs). Piperacillin is stable against hydrolysis by a variety of beta-lactamases, including penicillinases, and cephalosporinases and extended spectrum beta-lactamases.

Mechanism of action

Tazobactam broadens the spectrum of piperacillin and ceftolozane by making them effective against organisms that express beta-lactamase and would normally degrade them. This occurs through the irreversible inhibition of beta-lactamase enzymes. In addition, tazobactam may bind covalently to plasmid-mediated and chromosome-mediated beta-lactamase enzymes. Tazobactam is predominantly effective against the OHIO-1, SHV-1, and TEM groups of beta-lactamases, but may also inhibit other beta-lactamases. Tazobactam shows little antibacterial activity by itself, and for this reason, is generally not administered alone.

Pharmacodynamics

Tazobactam inhibits the action of bacterial beta-lactamase producing organisms, which are normally resistant to beta-lactam antibiotics. This augments the effects of antibiotics which would otherwise not be effective in treating certain infections. These antibiotics contain a beta-lactam ring in their chemical structure, which is destroyed by beta-lactam resistant organisms. When combined with other antibiotics, a variety of infections, including serious and life-threatening infections may be treated.