Tando (4.5g/20ml) 1 Vial Injection

Piperacillin tazobactam injection is a combination antibiotic that exhibits bactericidal activity by inhibiting cell wall synthesis in susceptible bacteria. Piperacillin, a broad-spectrum beta-lactam antibiotic, disrupts the synthesis of the peptidoglycan layer by binding to penicillin-binding proteins (PBPs), which are essential for cross-linking the peptidoglycan chains. Tazobactam, a beta-lactamase inhibitor, protects piperacillin from degradation by blocking the activity of beta-lactamase enzymes produced by certain bacteria, thereby extending the spectrum of activity and enhancing the effectiveness of piperacillin against beta-lactamase-producing organisms. Together, this combination prevents the formation of a structurally strong cell wall, leading to cell lysis and bacterial death.

Penicillin/beta-lactamase inhibitor

Injection

The following are the uses of piperacillin tazobactam injection:

• Used for treating severe, life-threatening infections caused by multiple-drug-resistant bacteria.
• Used for broad-spectrum coverage against a wide range of bacteria, including penicillin-resistant strains.
• Used for treating complicated intra-abdominal infections, skin and skin structure infections, and community-acquired pneumonia.
• Used for surgical prophylaxis in high-risk procedures to prevent post-operative infections.
• Used for treating hospital-acquired infections, including ventilator-associated pneumonia and complicated urinary tract infections.
• Used for managing infections in immunocompromised patients, such as those with neutropenia.
• Used for empiric therapy in critically ill patients until definitive culture results are available.

In the case of an overdose of piperacillin tazobactam injection, it is crucial to seek medical assistance promptly. Overdose symptoms may include seizures, confusion, and changes in urination patterns. Immediate treatment involves managing these symptoms and providing supportive care. Medical professionals will focus on stabilizing the patient, monitoring vital signs, and ensuring proper organ function. Timely intervention is essential to minimize potential complications.

In the case of a missed dose of piperacillin tazobactam injection, it is important to administer the medication as soon as possible. However, if it is almost time for the next scheduled dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to make up for the missed one, as this may increase the risk of side effects. If you miss multiple doses, contact your healthcare professional for advice on how to proceed and to ensure the treatment remains effective.

To administer Piperacillin Tazobactam injection, gently swirl the vial to ensure the powder is loose, reconstitute it with the provided sterile water, inject the calculated dose into the intravenous fluid, and infuse the solution slowly over 30 minutes for immediate use or store it in the refrigerator for later administration.

Here are the conditions and situations when piperacillin tazobactam injection should not be used:

• Must not be used in individuals with a known allergy to piperacillin, tazobactam, penicillin, or any other beta-lactam antibiotics.
• Contraindicated in patients with a history of severe allergic reactions, especially those with a history of anaphylaxis.
• Should not be used in patients with severe kidney disease or those on dialysis, as dose adjustments are required.
• Not recommended for individuals with a history of seizures or conditions that lower the seizure threshold.
• Avoid using in patients with a history of gastrointestinal diseases such as colitis or antibiotic-associated diarrhea.
• Piperacillin tazobactam should not be used in newborns, especially preterm infants, due to the risk of bilirubin encephalopathy.
• Contraindicated in patients with a history of Stevens-Johnson syndrome or toxic epidermal necrolysis.
• Not suitable for individuals with phenylketonuria, as some formulations may contain phenylalanine.

The side effects of piperacillin tazobactam injection may include:

• Nausea and vomiting
• Diarrhea
• Skin rashes or itching
• Headache
• Dizziness
• Injection site reactions (pain, swelling, or redness)
• Allergic reactions (hives, difficulty breathing, swelling of the face/lips/tongue)
• Changes in liver function tests

Following are the precautions and warnings for Piperacillin Tazobactam Injection:

• This medication should not be used in patients with a known allergy to piperacillin, tazobactam, or any penicillin-derived antibiotics.
• Prolonged use may lead to the overgrowth of non-susceptible organisms, and repeated evaluations are essential.
• Caution is advised for patients with a history of kidney or liver disease, as dosage adjustments may be necessary.
• It should be used with caution in patients with a history of seizures or neurological disorders.
• Elderly patients may be more susceptible to adverse reactions, particularly renal and neurological effects.
• Patients should be monitored for signs of superinfection and pseudomembranous colitis during and after treatment.
• Piperacillin tazobactam should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Following are the drug interactions for Piperacillin Tazobactam Injection:

• Probenecid can decrease the elimination of piperacillin, potentially leading to increased levels of the drug.
• Concurrent use with other nephrotoxic drugs (e.g., aminoglycosides, vancomycin) may increase the risk of kidney damage.
• May reduce the effectiveness of oral contraceptives, requiring additional contraceptive measures.
• It can decrease the efficacy of live attenuated vaccines, such as typhoid vaccine, due to its antibacterial activity.
• Piperacillin may alter the effectiveness of mycophenolate mofetil, a drug used in organ transplantation.
• Interactions with anticoagulants like warfarin are possible, requiring monitoring of coagulation parameters.
• Caution is advised when using with neuromuscular blocking agents, as it may prolong the duration of action of these agents.

Following are the food interactions for Piperacillin Tazobactam Injection:

• Avoid alcohol consumption during the treatment period as it may increase the risk of gastrointestinal side effects and impact the effectiveness of the medication.
• Grapefruit and grapefruit juice should be consumed with caution as they can interfere with the metabolism of the drug, potentially leading to increased levels of piperacillin and tazobactam in the body.
• Avoid high-fat meals as they may reduce the absorption of piperacillin and tazobactam, decreasing the overall effectiveness of the medication.
• Dairy products like milk, cheese, and yogurt may reduce the absorption of the medication, so it is best to separate them by a few hours when taking the injection.
• Antacids containing magnesium or aluminum can decrease the absorption of piperacillin and tazobactam. Avoid taking them together and maintain a gap of at least 2-3 hours.
• Vitamin C supplements or citrus fruits rich in vitamin C may alter the pH of urine, potentially affecting the excretion of the medication. Consult your healthcare provider for guidance.
• Foods containing high levels of sodium (salt) should be consumed in moderation as piperacillin and tazobactam can cause sodium and water retention.
• Always ensure you are well-hydrated when taking this medication, and maintain a balanced diet to support overall health during treatment.

Piperacillin tazobactam injection storage and disposal requires careful attention to maintain its integrity. Store the injection in a cool, dry place, preferably at room temperature, ensuring it is shielded from direct sunlight and moisture. Keep the vial tightly sealed in its original packaging to prevent contamination. Avoid extreme temperatures by not placing it in the bathroom or near heat sources. Regularly check the expiration date, and if the injection is no longer needed or has expired, proper disposal is crucial. Do not dispose of it through household waste or drainage systems; instead, consult a pharmacist or healthcare professional for guidance on safe disposal methods, ensuring environmental responsibility and preventing accidental access.

Following are the quick tips for Piperacillin Tazobactam Injection:

• Administer the injection under medical supervision; do not self-inject.
• Ensure the injection is prepared and administered by a trained healthcare professional.
• The injection is typically given intravenously over a period of 30 minutes.
• Inform your doctor if you have any allergies, especially to penicillin or similar antibiotics.
• Report any side effects like severe diarrhea, seizures, or unusual bleeding to your doctor promptly.
• Store the injection as directed on the packaging, usually at room temperature and away from light.
• Do not reuse needles or syringes; dispose of them safely after use.
• Complete the full course of treatment as prescribed, even if you feel better early on.