PIPTAZO 4.5G

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

• Intra-abdominal infections
• Skin and soft tissue infections
• Pneumonia
• Urinary tract infections
• Sepsis

Dosage

Children: Refer to the BNF for Children for appropriate dosing information, as paediatric doses depend on the specific indication and the antibiotic used in combination with tazobactam.

Adults: Refer to specific guidelines based on the combination antibiotic used with tazobactam, as doses may vary based on the indication and the presence of renal impairment.

Mechanism of action

Tazobactam works by irreversibly binding to the active site of beta-lactamase enzymes, which are produced by some bacteria to resist the effects of beta-lactam antibiotics. By inhibiting these enzymes, tazobactam protects the antibiotic from degradation, allowing it to exert its antibacterial effects against susceptible bacteria.

Pharmacodynamics

Tazobactam enhances the antibacterial activity of beta-lactam antibiotics by preventing the hydrolysis of the beta-lactam ring, which is essential for their antimicrobial action. This results in an increased susceptibility of bacteria that produce beta-lactamases, thereby improving the clinical outcomes in infections caused by resistant organisms.

Pharmacokinetics

Tazobactam is administered parenterally and is rapidly distributed in the body. It has a volume of distribution that indicates good tissue penetration. The drug is primarily eliminated by renal excretion, with a half-life that supports dosing in combination with other antibiotics. Its pharmacokinetics may be affected by renal function, and dose adjustments may be necessary in patients with impaired renal clearance.

Contra-indications

• Hypersensitivity to tazobactam or any component of the formulation
• Severe allergic reactions to beta-lactam antibiotics

Adverse effects

• Diarrhea
• Nausea
• Vomiting
• Rash
• Fever
• Elevated liver enzymes
• Renal impairment
• Anaphylactic reactions

Interactions

• May enhance the effects of anticoagulants like warfarin
• Potential for decreased efficacy with probenecid
• May interact with other nephrotoxic agents, increasing the risk of renal toxicity

Precautions

• Use with caution in patients with renal impairment
• Monitor for signs of anaphylaxis in patients with a history of allergies
• Consider renal function when dosing, especially in older adults

Pregnancy

Tazobactam is categorized as a pregnancy category B drug, indicating that animal reproduction studies have failed to demonstrate a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women.

Breast-feeding

Tazobactam is excreted in human milk. Caution should be exercised when administering to nursing mothers, as the effects on the infant are not well-studied.

Storage

Store at room temperature, away from moisture and heat. Protect from light.

Formulations

• Injectable solution
• Combination with piperacillin (e.g., piperacillin/tazobactam)

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.