Piperacillin

Overview
Piperacillin is an extended spectrum beta-lactam antibiotic of the ureidopenicillin class. It is normally used together with a beta-lactamase inhibitor such as tazobactam, which is commercially available as Tazocin or Zosyn. The combination has activity against many Gram-positive and Gram-negative pathogens and anaerobes, including Pseudomonas aeruginosa.

Piperacillin/tazobactam is administered intravenously. 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).

Dosing
Piperacillin is not absorbed orally, and must therefore be given by intravenous or intramuscular injection. The doses available differ slightly from country to country.

The doses listed here are adult doses. In the U.S., the dose is 3.375–4.5 g every 6 hours. In the UK, the usual dose is 4.5 g every 8 hours; but is licensed to be given as 2.25–4.5 g every 6–8 hours. The drug may also be given by continuous infusion, but this has not been shown to be superior.

Trade names and preparations
Piperacillin alone:
 * Pipracil (U.S. only)

Piperacillin/tazobactam:
 * Tazocin (UK, marketed by Lederle)
 * Tazocin (Japan, marketed by Toyama)
 * Tazocin (New Zealand, marketed by Wyeth)
 * Zosyn (U.S., marketed by Wyeth-Ayerst)