Brand Name: Tazep
Molecule: Piperacillin 4gm & Tazobactam 500mg
Dosage Form: Injection
Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, 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, including staphylococcal penicillinase and Richmond and Sykes types II, III, IV, and V, including extended spectrum enzymes; it has only limited activity against class I beta-lactamases other than class Ic types.
In adults and children over 12 years of age:
In children under 12 years of age:
Tazep should be administered by intravenous infusion over 30 minutes.
Adults: The usual total daily dose of Tazep is 3.375 g every six hours totaling 13.5 g (12.0 g piperacillin/1.5 g Tazobactam).
Initial presumptive treatment of patients with nosocomial pneumonia should start with PIPTAZIN at a dosage of 4.5 g every six hours plus an aminoglycoside, totaling 18.0 g (16.0 g piperacillin/2.0 g tazobactam). Treatment with the aminoglycoside should be continued in patients from whom Pseudomonas aeruginosa is isolated. If Pseudomonas aeruginosa is not isolated, the aminoglycoside may be discontinued at the discretion of the treating physician.
Pediatrics: For children with appendicitis and/or peritonitis 9 months of age or older, weighing up to 40 kg, and with normal renal function, the recommended piperacillin/tazobactam dosage is 100 mg piperacillin/12.5 mg tazobactam per kilogram of body weight, every 8 hours. For pediatric patients between 2 months and 9 months of age, the recommended piperacillin/tazobactam dosage based on pharmacokinetic modeling, is 80 mg piperacillin/10 mg tazobactam per kilogram of body weight, every 8 hours. Pediatric patients weighing over 40 kg and with normal renal function should receive the adult dose. There are no dosage recommendations for piperacillin/tazobactam in pediatric patients with impaired renal function.
Duration of Therapy:
The usual duration of Tazep treatment is from seven to ten days. However, the recommended duration of Tazep treatment of nosocomial pneumonia is 7 to 14 days. In all conditions, the duration of therapy should be guided by the severity of the infection and the patient`s clinical and bacteriological progress.
In patients with renal insufficiency (creatinine clearance < 40 mL/min), the intravenous dose of Tazep should be adjusted to the degree of actual renal function impairment. In patients with nosocomial pneumonia receiving concomitant aminoglycoside therapy, the aminoglycoside dosage should be adjusted according to the recommendations of the manufacturer. The recommended daily doses of Tazep for patients with renal insufficiency are as follows: Adults:
Recommended Dosing of Tazep in Patients with Normal Renal Function and Renal Insufficiency (As total grams piperacillin/tazobactam):
|Renal Function (Creatinine Clearance, mL/min)||All Indications (except nosocomial pneumonia)||Nosocomial Pneumonia|
|> 40 mL/min||3.375 q 6 h||4.5 q 6 h|
|> 20-40 mL/min *||2.25 q 6 h||3.375 q 6 h|
|< 20 mL/min *||2.25 q 8 h||2.25 q 8 h|
|Haemodialysis **||2.25 q 12 h||2.25 q 8 h|
|CAPD||2.25 q 12 h||2.25 q 8 h|
|* Creatinine clearance for patients not receiving haemodialysis|
|** 0.75 g should be administered following each haemodialysis session on haemodialysis days|
For patients on haemodialysis, the maximum dose is 2.25 g every twelve hours for all indications other than nosocomial pneumonia and 2.25 g every eight hours for nosocomial pneumonia. Since haemodialysis removes 30% to 40% of the administered dose, an additional dose of 0.75 g PIPTAZIN should be administered following each dialysis period on haemodialysis days. No additional dosage of Tazep is necessary for CAPD patients.
There are no dosage recommendations for piperacillin/tazobactam in pediatric patients with impaired renal function.
Directions for Reconstitution and Dilution for Use
Intravenous Administration: Reconstitute Tazep per gram of piperacillin with 5 mL of a compatible reconstitution diluent from the list provided below.
4.5 g Tazep should be reconstituted with 20 mL. Swirl until dissolved.
Use immediately after reconstitution. Discard any unused portion after 24 hours if stored at room temperature (20-25 Degree Celcius), or after 48 hours if stored at refrigerated temperature (20 – 80 Degree Celcius).
Piperacillin and tazobactam may cause side effects such as upset stomach , vomiting, unpleasant or abnormal taste, diarrhea, gas ,headache, constipation, insomnia, rash, itching skin, swelling, shortness of breath, unusual bruising or bleeding.
Tazep is contraindicated in patients with a history of allergic reactions to any of the penicillins, cephalosporins, or beta-lactamase inhibitors.