PIPZO 4.5 GM

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 specific paediatric dosing guidelines based on age, weight, and indication.

Adults: Refer to the BNF for specific adult dosing guidelines based on the indication and renal function.

Mechanism of action

Tazobactam works by binding to and irreversibly inactivating various types of β-lactamases, which are enzymes produced by some bacteria that confer resistance to β-lactam antibiotics. By inhibiting these enzymes, tazobactam restores the antibacterial activity of β-lactam antibiotics, allowing them to effectively kill bacteria that would otherwise be resistant.

Pharmacodynamics

The pharmacodynamic properties of tazobactam are closely related to its role as a β-lactamase inhibitor. It enhances the activity of β-lactam antibiotics, allowing these drugs to maintain their efficacy against susceptible and resistant organisms. The combination of tazobactam with piperacillin, for example, results in a broader spectrum of antimicrobial activity compared to piperacillin alone.

Pharmacokinetics

Tazobactam is administered intravenously and has a volume of distribution of approximately 0.2 L/kg. It is primarily eliminated via the kidneys, with 70-80% of an administered dose excreted unchanged in the urine. The elimination half-life of tazobactam is approximately 1 hour. Renal impairment may necessitate dosage adjustments to prevent accumulation.

Pregnancy

There is limited data on the use of tazobactam in pregnancy. It should only be used if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Tazobactam is excreted in breast milk. Caution should be exercised when administering to nursing mothers.

Storage

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

Formulations

• {'name': 'Tazobactam', 'form': 'Injection', 'strength': 'various strengths available'}

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.