Spectrum: Local Antimicrobial Stewardship, for Billings Clinic

Piperacillin-Tazobactam

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

$8-15/day

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Renal

Pediatric

Adult

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

General Information

Unacceptable Uses

Unacceptable Uses

Meningitis

Common Usage

Common Usage

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

Drug Monitoring

Drug Monitoring

Long term: weekly CBC, CMP

Adverse Effects

Adverse Effects

  • Allergy/rash (immediate or delayed)

  • Cytopenias- esp. thrombocytopenia

  • Eosinophilia

  • Interstitial nephritis

  • Abnormal liver enzymes

Major Interactions

Major Interactions

Incr. levels of methotrexate

Additional Information

Additional Information

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

Pharmacology

Pharmacology

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