Uses of Tazopen: - Bacterial infections Septicaemia, Nosocomial pneumonia Hypersensitivity.

Broad spectrum penicillins, Other beta-lactam Antibiotics

Piperacillin, a broad spectrum, semi-synthetic penicillin active against many gram-positive and gram-negative aerobic and anaerobic bacteria, exerts bactericidal activity by inhibition of both septum and cell wall synthesis.Tazobactam is a penicillanic acid sulfone derivative with β-lactamase inhibitory properties. In combination, tazobactam enhances the activity of piperacillin against β-lactamase-producing bacteria. Piperacillin and tazobactam has a wide range of activity and is active against gm+ve and gm-ve aerobic and anaerobic bacteria.

How to use Piperacillin + Tazobactam: Your doctor or nurse will give you this medicine. Kindly do not self administer. Administration: Reconstitution Reconstitute initially (2.25 g in 10 mL, 4.5 g in 20 mL) w/ water for inj, glucose 5% or NaCl 0.9%, then further dilute to 50-150 mL w/ compatible infusion soln. IV Administration Infusion over 30 min Adult Dose: Intravenous Nosocomial pneumonia Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam 0.5 g): 4.5 g 6 hrly for 5-14 days by infusion over 30 min. When used empirically, combination w/ aminoglycoside or antipseudomonal fluoroquinolone is recommended. Empiric therapy for febrile neutropenic patients Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam 0.5 g): 4.5 g 6 hrly for 5-14 days by infusion over 30 min. Complicated intra-abdominal infections Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam 0.5 g): 4.5 g 8 hrly for 5-14 days by infusion over 30 min. Complicated urinary tract infections; Skin and soft tissue infections Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam 0.5 g): 4.5 g 8 hrly for 5-14 days by infusion over 30 min. Child Dose: Intravenous Child: Usually <40 kg: 240–300 mg PIP/kg/day 8 hourly Alternatively Nosocomial pneumonia Child: 2-12 yr 90 mg/kg (piperacillin 80 mg/kg and tazobactam 10 mg/kg) 6 hrly for 5-14 days by infusion over 30 min. Max: 4.5 g per dose; >12 yr Same as adult dose. Empiric therapy for febrile neutropenic patients Child: 2-12 yr 90 mg/kg (piperacillin 80 mg/kg and tazobactam 10 mg/kg) 6 hrly for 5-14 days by infusion over 30 min. Max: 4.5 g per dose; >12 yr Same as adult dose. Complicated intra-abdominal infections Child: 2-12 yr 112.5 mg/kg (piperacillin 100 mg and tazobactam 12.5 mg) 8 hrly for 5-14 days by infusion over 30 min. Max: 4.5 g per dose. Renal Dose: Renal impairment: Haemodialysis patients: 2.25 g 12 hrly; additional dose of 0.75 g after each dialysis session. CAPD: 2.25 g 12 hrly. CrCl (ml/min) Dosage Recommendation <20 2.25 g 8 hrly. 20-40 2.25 g 6 hrly.

Interacts w/ high doses of heparin, oral anticoagulants or other drugs that affect blood coagulation or thrombocyte function. Prolongs the neuromuscular blockade of vecuronium and non-depolarising muscle relaxants. Prolongs half-lives w/ probenecid. Increased risk of methotrexate toxicity.

Hypersensitivity.

Common - Nausea - Vomiting - Diarrhea - Rash - Allergic reaction >10% Diarrhea (7-11%) 1-10% Constipation (1-8%),Headache (1-8%),Insomnia (4-7%),Nausea (2-7%),Fever (2-5%),Oral candidiasis (2-4%),Rash (2-4%),Vomiting (2-4%),Dyspepsia (3%),Pruritus (3%),Pain (2-3%),Hypertension (2%),Leukopenia (1%),Thrombocytopenia (1.4%) <1% Anaphylaxis,Agranulocytosis,Thrombocytopenia,Eosinophilia,Leukopenia,Positive Coombs test,Prolonged PT and PTT,Transient LFT and creatinine elevations.Seizure,Pulmonary edema,Pulmonary embolism

Pregnancy Category B. Piperacillin and tazobactam cross the placenta in humans. Piperacillin is excreted in low concentrations in human milk; tazobactam concentrations in human milk have not been studied. Caution should be exercised when piperacillin and tazobactam for IV infusion is administered to a nursing woman

Precaution: Pregnancy and lactation, pseudomembranous colitis. Assess hematopoietic function periodically. Perform periodic electrolyte determinations in patients with low K reserves. Increased risk of fever and rash in patients with cystic fibrosis. Increased risk of bleeding manifestations. Prolonged treatment may increase risk of superinfections. Convulsions or neuromuscular excitability may occur when high doses are used, especially in renally impaired patients. Renal impairment. Lactation: Low concentrations of piperacillin excreted in breast milk; tazobactam unknown; use caution

There have been post marketing reports of overdose with piperacillin/tazobactam. The majority of those events experienced, including nausea, vomiting, and diarrhea, have also been reported with the usual recommended dosages. Patients may experience neuromuscular excitability or convulsions if higher than recommended doses are given intravenously (particularly in the presence of renal failure). Treatment should be supportive and symptomatic according the patient's clinical presentation.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Broad spectrum penicillins, Other beta-lactam Antibiotics

Piperacillin has an antimicrobial activity against a wide range of gm-ve organisms including K. pneumoniae, P. aeruginosa, Enterobacteriaceae and against gm+ve organisms eg E. faecalis and B. fragilis. Tazobactam is a penicillanic acid sulfone derivative with beta-lactamase inhibitory properties. In combination, tazobactam enhances the activity of piperacillin against beta-lactamase-producing bacteria.

Piperacillin and tazobactam cross the placenta in humans. However, there are insufficient data with piperacillin and/or tazobactam in pregnant women to inform a drug-associated risk for major birth defects and miscarriage. Piperacillin is excreted in human milk; tazobactam concentrations in human milk have not been studied. No information is available on the effects of piperacillin and tazobactam on the breastfed child or on milk production.