Piperacillin/tazobactam

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Piperacillin/tazobactam
Combination of
Piperacillin Ureidopenicillin antibiotic
Tazobactam Beta-lactamase inhibitor
Clinical data
Trade names Tazocin, Zosyn, others
AHFS/Drugs.com Monograph
MedlinePlus a694003
Pregnancy
category
  • US: B (No risk in non-human studies)
Routes of
administration
Intravenous infusion
ATC code
Legal status
Legal status
Identifiers
CAS Number
PubChem CID
ChemSpider
ChEMBL
 NYesY (what is this?)  (verify)

Piperacillin/tazobactam, sold under the brand name Tazocin among others, is a combination medication containing the antibiotic piperacillin and the β-lactamase inhibitor tazobactam.[1] The combination has activity against many Gram-positive and Gram-negative bacteria including Pseudomonas aeruginosa.[1] It is used to treat pelvic inflammatory disease, intraabdominal infection, pneumonia, cellulitis, and sepsis.[1] It is given by injection into a vein.[2]

Common side effects include headache, trouble sleeping, rash, nausea, constipation, and diarrhea.[1] Serious side effects include Clostridium difficile infection and allergic reactions including anaphylaxis.[1] Those who are allergic to other β-lactam are more likely to be allergic to piperacillin/tazobactam.[1] Use in pregnancy or breastfeeding appears to generally be safe.[3] It usually results in bacterial death through blocking their ability to make a cell wall.[1]

Piperacillin/tazobactam was approved for medical use in the United States in 1993.[1] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[4] It is available as a generic medication.[2] The wholesale cost in the developing world, as of 2015, is about 11 USD per day.[5] In the United Kingdom, as of 2015, this amount costs the NHS about 38.70 pounds per day.[2]

Medical uses[edit]

Its main uses are in intensive care medicine (pneumonia, peritonitis), some diabetes-related foot infections, and empirical therapy in febrile neutropenia (e.g., after chemotherapy). The drug is administered intravenously every 6 or 8 hr, typically over 3–30 min. It may also be administered by continuous infusion over four hours. Prolonged infusions are thought to maximize the time that serum concentrations are above the minimum inhibitory concentration (MIC) of the bacteria implicated in infection.

Piperacillin-tazobactam is recommended by the National Institute for Health and Care Excellence as first line therapy for the treatment of bloodstream infections in neutropenic cancer patients.[6]

Adverse effects[edit]

The most common adverse effect is diarrhea (7–11%).[7] Another adverse effect is inhibition of platelets (thrombocytopenia).[8]

Society and culture[edit]

Trade names[edit]

Apart from Tazocin and Zosyn, the drug is marketed in various countries under other trade names such as Tazact, Biopiper TZ, Brodactam, Piptaz, Maxitaz, Kilbac, Trezora, Du-Tazop, Tazopen, Sytaz, and Inzalin TZ.

2017 shortage[edit]

Various sources have referred to a shortage of the drug since May 2017, citing various reasons, including an earthquake in China and other issues at the major production facility in 海正 (Hisun); increased demand; withdrawal of funding by a major pharmaceutical company.[9][10]

References[edit]

  1. ^ a b c d e f g h "Piperacillin Sodium and Tazobactam Sodium". The American Society of Health-System Pharmacists. Retrieved 8 December 2017. 
  2. ^ a b c British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 373. ISBN 9780857111562. 
  3. ^ "Piperacillin / tazobactam (Zosyn) Use During Pregnancy". Drugs.com. Retrieved 10 December 2017. 
  4. ^ "WHO Model List of Essential Medicines (20th List)" (PDF). World Health Organization. March 2017. Retrieved 29 June 2017. 
  5. ^ "Single Drug Information". International Medical Products Price Guide. Retrieved 10 December 2017. 
  6. ^ "Neutropenic Sepsis: Prevention and Management of Neutropenic Sepsis in Cancer Patients - National Library of Medicine - PubMed Health". 
  7. ^ "Piperacillin and Tazobactam Sodium". Merck Manual Professional. Archived from the original on November 20, 2010. 
  8. ^ Rousan TA, Aldoss IT, Cowley BD Jr, Curtis BR, Bougie DW, Aster RH, George JN (January 2010). "Recurrent acute thrombocytopenia in the hospitalized patient: Sepsis, DIC, HIT, or antibiotic-induced thrombocytopenia". 85 (1): 71–74. doi:10.1002/ajh.21536. PMC 4410979Freely accessible. PMID 19802882. 
  9. ^ "Drug Shortages › Piperacillin Tazobactam Injection". Drugs.com. 10 July 2017. Retrieved 12 July 2017. 
  10. ^ "Major shortage forces doctors to ration important antibiotic". RT.com. 1 July 2017. Retrieved 12 July 2017.