This is indicated for the treatment of the following systemic and/or local bacterial infections:
Nosocomial pneumonia (moderate to severe)
Community-acquired pneumonia (moderate severity only)
Uncomplicated and complicated skin and skin structure infections, including cellulitis, cutaneous
Abscesses and ischemic/diabetic foot infections
Postpartum endometritis or pelvic inflammatory disease
Appendicitis (complicated by rupture or abscess) and peritonitis
Management of neutropenic patients (adults, adolescents and children) with fever suspected to be due to bacterial infections.
Side Effects
Adverse events primarily involving the skin, including rash and pruritus; the gastrointestinal system, including diarrhea, nausea, and vomiting; and allergic reactions. Adverse local reactions that were reported, irrespective of relationship to therapy with piperacillin and tazobactam were phlebitis, IV infusion site reaction, pain, infiammation, thrombophlebitis, and edema. Gastrointestinal-hepatitis, cholestatic jaundice. Hematologic-hemolytic anemia, anemia, thrombocytosis, agranulocytosis, pancytopenia. Immune hypersensitivity reactions, anaphylactic/anaphylactoid reactions (including shock). Infections-candidal superinfections. Renal-interstitial nephritis, renal failure. Skin and Appendages-erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.
Precautions & Warnings
Bleeding manifestations have occurred in some patients receiving j3-lactam antibiotics, including piperacillin. These reactions have sometimes been associated with abnormalities of coagulation tests such as clotting time, platelet aggregation and prothrombin time, and are more likely to occur in patients with renal failure. If bleeding manifestations occur, piperacillin and tazobactam for IV infusion should be discontinued and appropriate therapy instituted. The possibility of the emergence of resistant organisms that might cause superinfections should be kept in mind. If this occurs, appropriate measures should be taken. As with other penicillins, patients may experience neuromuscular excitability or convulsions if higher than recommended doses are given intravenously (particularly in the presence of renal failure). piperacillin and tazobactam contains a total of 2.79 mEq (64 mg) of Na+ per gram of piperacillin in the combination product. This should be considered when treating patients requiring restricted salt intake. Periodic electrolyte determinations should be performed in patients with low potassium reserves, and the possibility of hypokalemia should be kept in mind with patients who have potentially low potassium reserves and who are receiving cytotoxic therapy or diuretics. As with other semisynthetic penicillins, piperacillin therapy has been associated with an increased incidence of fever and rash in cystic fibrosis patients. In patients with cteatinine clearance> 40 mL/min and dialysis patients (hemodialysis and CAPO), the intravenous dose should be adjusted to the degree of renal function impairment.
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