piperacillin and tazobactam

Generic Name: piperacillin and tazobactam (pi PER a sil in and tay zoe BAK tam)

Brand Names: Zosyn

What is piperacillin and tazobactam?

Piperacillin is a penicillin antibiotic that fights bacteria in the body.

Tazobactam is an antibiotic similar to a penicillin that fights bacteria in the body.

The combination of piperacillin and tazobactam is used to treat many different infections caused by bacteria, such as urinary tract infections, bone and joint infections, severe vaginal infections, stomach infections, skin infections, and pneumonia.

This medication is sometimes given together with other antibiotics.

Piperacillin and tazobactam may also be used for purposes not listed in this medication guide.

What is the most important information I should know about piperacillin and tazobactam?

You should not use this medication if you are allergic to piperacillin and tazobactam or to any other penicillin antibiotic, such as amoxicillin (Amoxil, Augmentin, Dispermox, Moxatag), ampicillin (Principen, Unasyn), dicloxacillin (Dycill, Dynapen), oxacillin (Bactocill), ticarcillin (Timentin), or penicillin (Bicillin L-A, PC Pen VK, Pfizerpen), and others.

Before using piperacillin and tazobactam tell your doctor if you have kidney disease, a bleeding or blood clotting disorder, low levels of potassium in your blood, cystic fibrosis, a history of allergies, if you are on a low-salt diet, or if you are allergic to a cephalosporin antibiotic such as cefdinir (Omnicef), cefprozil (Cefzil), cefuroxime (Ceftin), cephalexin (Keflex), and others.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Piperacillin and tazobactam will not treat a viral infection such as the common cold or flu.

Piperacillin and tazobactam may cause bleeding, especially in people with kidney disease or using certain medicines. Tell your doctor if you are using any medication to prevent blood clots such as alteplase (Activase), bivalirudin (Angiomax), clopidogrel (Plavix), dabigatran (Pradaxa), dipyridamole (Persantine, Aggrenox), enoxaparin (Lovenox), fondaparinux (Arixtra), heparin, tenecteplase (TNKase), ticlopidine (Ticlid), tinzaparin (Innohep), warfarin (Coumadin, Jantoven), and others.

What should I discuss with my healthcare provider before using piperacillin and tazobactam?

You should not use this medication if you are allergic to piperacillin and tazobactam or to any other penicillin antibiotic, such as:

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  amoxicillin (Amoxil, Augmentin, Dispermox, Moxatag);

  
  


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  ampicillin (Principen, Unasyn);

  
  


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  dicloxacillin (Dycill, Dynapen);

  
  


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  oxacillin (Bactocill);

  
  


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  ticarcillin (Timentin); or

  
  


• 
  

  penicillin (Bicillin L-A, PC Pen VK, Pfizerpen), and others.

  
  

To make sure you can safely use piperacillin and tazobactam, tell your doctor if you have any of these other conditions:

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  kidney disease (or if you are on dialysis);

  
  


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  a bleeding or blood clotting disorder;

  
  


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  an electrolyte imbalance such as low levels of potassium in your blood;

  
  


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  cystic fibrosis;

  
  


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  a history of any type of allergy;

  
  


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  if you are on a low-salt diet; or

  
  


• 
  

  if you are allergic to a cephalosporin antibiotic such as cefdinir (Omnicef), cefprozil (Cefzil), cefuroxime (Ceftin), cephalexin (Keflex), and others.

  
  

FDA pregnancy category B. Piperacillin and tazobactam is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Piperacillin and tazobactam may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use piperacillin and tazobactam?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Piperacillin and tazobactam is injected into a vein through an IV. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Piperacillin and tazobactam must be given slowly, and the IV infusion can take at least 30 minutes to complete.

Piperacillin and tazobactam must be mixed with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medication.

Prepare your dose in a syringe, IV bag, or infusion pump only when you are ready to give yourself an injection. Do not use the medication if it has changed colors or has particles in it. Call your doctor for a new prescription.

Piperacillin and tazobactam is usually given for 7 to 10 days, depending on the infection being treated. Follow your doctor's instructions.

If you use this medication long-term, your blood will need to be tested often. Visit your doctor regularly.

Use a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Piperacillin and tazobactam will not treat a viral infection such as the common cold or flu.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using piperacillin and tazobactam.

Store unmixed medicine and the liquid diluent at cool room temperature.

Medicine mixed in an IV bag must be used within 24 hours if you keep it at room temperature.

Mixed medicine in an infusion pump must be used within 12 hours if you keep it at room temperature.

Mixed medication in an IV bag can also be stored in the refrigerator for up to 7 days. Do not freeze. Throw away any unused mixture that has not been used within that time.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe anxiety, agitation, feeling restless or nervous, or seizure (convulsions).

What should I avoid while using piperacillin and tazobactam?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Piperacillin and tazobactam side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

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  diarrhea that is watery or bloody;

  
  


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  pale or yellowed skin, dark colored urine, fever, confusion or weakness;

  
  


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  feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  
  


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  easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  
  


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  dry mouth, increased thirst, confusion, increased urination, muscle pain or weakness, fast heart rate, feeling light-headed, fainting;

  
  


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  fever, chills, body aches, flu symptoms;

  
  


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  white patches or sores inside your mouth or on your lips; or

  
  


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  seizure (convulsions).

  
  

Less serious side effects may include:

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  nausea, vomiting, stomach pain or upset;

  
  


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  constipation, mild diarrhea;

  
  


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  headache, dizziness, agitation;

  
  


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  runny nose;

  
  


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  anxiety, sleep problems (insomnia);

  
  


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  skin rash or itching;

  
  


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  pain, swelling, or other irritation where the injection was given; or

  
  


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  vaginal itching or discharge.

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Piperacillin and tazobactam Dosing Information

Usual Adult Dose for Aspiration Pneumonia:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: Parenteral therapy should be continued until the patient's clinical condition stabilizes and fever subsides. Oral antibiotic therapy may then be substituted according to microbiology sensitivity data. Therapy of documented anaerobic pleuropulmonary infections should be continued until the infiltrate is cleared, or a residual scar forms, sometimes for as long as 2 to 4 months.

Usual Adult Dose for Bacteremia:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: for approximately 14 days, depending on the nature and severity of the infection; once the patient is stable and able to tolerate oral medications, oral antibiotic therapy may be substituted according to microbiology sensitivity data

In severe infections, piperacillin trough levels (drawn immediately before the 4th or 5th dose) may be helpful. Serum piperacillin trough levels greater than 16 mcg/mL have been associated with improved efficacy.

Usual Adult Dose for Deep Neck Infection:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: for approximately 2 to 3 weeks, depending on the nature and severity of the infection; once the patient is stable and able to tolerate oral medications, oral antibiotic therapy may be substituted according to microbiology sensitivity data

Usual Adult Dose for Endometritis:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: Parenteral therapy should be continued for at least 24 hours after the patient has remained afebrile, pain-free, and the leukocyte count has normalized. Doxycycline therapy for 14 days is recommended if concurrent chlamydial infection is present in late postpartum patients (breast-feeding should be discontinued).

Usual Adult Dose for Febrile Neutropenia:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: Therapy should be continued for about 14 days, or until more specific therapy may be substituted for a proven infection, or until the patient is afebrile for 24 hours after the absolute neutrophil count is greater than 500/mm3. The total duration of therapy depends on the nature and severity of the infection. Once the patient is stable and able to tolerate oral medications, oral antibiotic therapy may be substituted according to microbiology sensitivity data.

In severe infections, piperacillin trough levels (drawn immediately before the 4th or 5th dose) may be helpful. Serum piperacillin trough levels greater than 16 mcg/ml have been associated with improved efficacy.

Usual Adult Dose for Intraabdominal Infection:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: for 7 to 10 days, depending on the nature and severity of the infection; once the patient is stable and able to tolerate oral medications, oral antibiotic therapy may be substituted according to microbiology sensitivity data

In severe infections, piperacillin trough levels (drawn immediately before the 4th or 5th dose) may be helpful. Serum piperacillin trough levels greater than 16 mcg/mL have been associated with improved efficacy.

Usual Adult Dose for Joint Infection:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: Therapy should be continued for approximately 3 to 4 weeks, depending on the nature and severity of the infection. Longer therapy, 6 weeks or more, may be required for prosthetic joint infections. In addition, removal of the involved prosthesis is usually required.

Usual Adult Dose for Nosocomial Pneumonia:

Moderate to severe: 4.5 g IV every 6 hours
Duration: for 7 to 14 days, depending on the nature and severity of the infection

Initial empiric treatment with broad-spectrum coverage according to the hospital's and/or ICU's antibiogram is recommended if multidrug-resistant organisms are suspected.

If the causative organism is not Pseudomonas aeruginosa, the duration of treatment should be as short as clinically possible (e.g., as little as 7 days) to reduce the risk of superinfections with resistant organisms.

Usual Adult Dose for Osteomyelitis:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: Therapy should be continued for approximately 4 to 6 weeks, depending on the nature and severity of the infection. Chronic osteomyelitis may require additional oral antibiotic therapy, possibly for up to 6 months. Surgical debridement of devitalized bone is critical to the management of osteomyelitis.

Usual Adult Dose for Pelvic Inflammatory Disease:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: for 7 to 10 days, depending on the nature and severity of the infection

If the patient is not pregnant, oral doxycycline therapy for 14 days should be considered to treat possible concurrent chlamydial infection. The patient's sexual partner(s) should also be evaluated.

Usual Adult Dose for Peritonitis:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: for 7 to 10 days, depending on the nature and severity of the infection

Usual Adult Dose for Skin or Soft Tissue Infection:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: for 7 to 10 days, depending on the nature and severity of the infection

Usual Adult Dose for Pneumonia:

Moderate community-acquired pneumonia: 3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: for 7 to 10 days, depending on the nature and severity of the infection

Usual Adult Dose for Pyelonephritis:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: for approximately 14 days, depending on the nature and severity of the infection; once the patient is stable and able to tolerate oral medications, oral antibiotic therapy may be substituted according to microbiology sensitivity data

Usual Adult Dose for Urinary Tract Infection:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used
Duration: for approximately 7 to 10 days, depending on the nature and severity of the infection; once the patient is stable and able to tolerate oral medications, oral antibiotic therapy may be substituted according to microbiology sensitivity data

Usual Pediatric Dose for Appendectomy:

2 to 9 months: 80 mg-10 mg/kg piperacillin-tazobactam IV every 8 hours
9 months or older (less than 40 kg): 100 mg-12.5 mg/kg piperacillin-tazobactam IV every 8 hours

Pediatric patients weighing over 40 kg with normal renal function should receive adult dose.

Usual Pediatric Dose for Peritonitis:

2 to 9 months: 80 mg-10 mg/kg piperacillin-tazobactam IV every 8 hours
9 months or older (less than 40 kg): 100 mg-12.5 mg/kg piperacillin-tazobactam IV every 8 hours

Pediatric patients weighing over 40 kg with normal renal function should receive adult dose.

What other drugs will affect piperacillin and tazobactam?

Piperacillin and tazobactam may cause bleeding, especially in people with kidney disease or using certain medicines. Tell your doctor if you are using any medication to prevent blood clots, such as:

• 
  

  abciximab (ReoPro);

  
  


• 
  

  alteplase (Activase);

  
  


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  anagrelide (Agrylin);

  
  


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  argatroban (Acova);

  
  


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  bivalirudin (Angiomax);

  
  


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  cilostazol (Pletal);

  
  


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  clopidogrel (Plavix);

  
  


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  dipyridamole (Persantine);

  
  


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  dabigatran (Pradaxa);

  
  


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  dalteparin (Fragmin);

  
  


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  dipyridamole (Persantine, Aggrenox);

  
  


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  enoxaparin (Lovenox);

  
  


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  eptifibatide (Integrelin);

  
  


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  fondaparinux (Arixtra);

  
  


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  heparin;

  
  


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  lepirudin (Refludan);

  
  


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  prasugrel (Effient);

  
  


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  tenecteplase (TNKase);

  
  


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  ticlopidine (Ticlid);

  
  


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  tinzaparin (Innohep);

  
  


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  tirofiban (Aggrastat);

  
  


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  urokinase (Abbokinase); or

  
  


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  warfarin (Coumadin, Jantoven).

  
  

Tell your doctor about all other medicines you use, especially:

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  probenecid (Benemid); or

  
  


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  another antibiotic such as kanamycin (Kantrex), neomycin (Mycifradin, Neo Fradin, Neo Tab), paromomycin (Humatin, Paromycin), streptomycin, tobramycin (Nebcin, Tobi).

  
  

This list is not complete and other drugs may interact with piperacillin and tazobactam. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More piperacillin and tazobactam resources

• Piperacillin and tazobactam Side Effects (in more detail)
• Piperacillin and tazobactam Dosage
• Piperacillin and tazobactam Use in Pregnancy & Breastfeeding
• Piperacillin and tazobactam Drug Interactions
• Piperacillin and tazobactam Support Group
• 1 Review for Piperacillin and tazobactam - Add your own review/rating

Compare piperacillin and tazobactam with other medications

• Appendectomy
• Aspiration Pneumonia
• Bacteremia
• Bone infection
• Deep Neck Infection
• Endometritis
• Febrile Neutropenia
• Intraabdominal Infection
• Joint Infection
• Kidney Infections
• Nosocomial Pneumonia
• Pelvic Inflammatory Disease
• Peritonitis
• Pneumonia
• Skin Infection
• Urinary Tract Infection

Where can I get more information?

• Your doctor or pharmacist can provide more information about piperacillin and tazobactam.

See also: piperacillin and tazobactam side effects (in more detail)