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Therapeutic Category Antibiotic Pharmacologic class: Penicillin Use\ Indications Treatment of infections of lower respiratory tract, urinary tract, skin and skin structures, gynecologic, bone and joint infections, and septicemia caused by susceptible organisms. Tazobactam expands activity of piperacillin to include beta-lactamase producing strains of S. aureus, H. influenzae, Bacteroides, and other gram-negative bacteria. Pharmacological Effects Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin binding proteins (PBPs), thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested. Tazobactam inhibits many beta-lactamases. Adverse Reaction Gastrointestinal: Diarrhea Constipation, nausea, vomiting/dyspepsia Cardiovascular: Hypertension Central nervous system: Insomnia, headache, agitation, fever, dizziness Dermatologic: Rash, pruritus Respiratory: Rhinitis/dyspnea Miscellaneous: Serum sickness-like reaction, Hypotension, edema, confusion, pseudomembranous colitis, bronchospasm Precautions/Warnings/Contraindication Due to sodium load and to the adverse effects of high serum concentrations of penicillins, dosage modification is required in patients with impaired or underdeveloped renal function; use with caution in patients with seizures or in patients with history of beta-lactam allergy; safety and efficacy have not been established in children <12 years of age Pregnancy category: B Interactions: Decreased effect: Tetracyclines may decrease penicillin effectiveness; decreased efficacy of oral contraceptives is possible Increased effect: Probenecid may increase penicillin levels Neuromuscular blockers may increase duration of blockade Aminoglycosides synergistic efficacy Heparin with high-dose parenteral penicillins may result in increased risk of bleeding

Dosing Children >12 years and Adults:Severe infections: I.V.: Piperacillin/tazobactam 4/0.5 g every 8 hours or 3/0.375 g every 6 hours

Dosing adjustment in renal impairment

Brand Available: Tanzo 4.5g piperacillin Tanzo 2.25 piperacillin