Piperacillin
Encyclopedia
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
. The combination drug piperacillin/tazobactam
is commercially available as e.g. Tazocin, Zosyn, Brodactam, Piptaz and as Trezora. The combination has activity against many Gram-positive
and Gram-negative
pathogens and anaerobes
, including Pseudomonas aeruginosa
.
or intramuscular injection
; piperacillin/tazobactam
is administered intravenously every 6 or 8 hours; the drug may also be given by continuous infusion. It has been shown that the bacteriocidal actions of the drug do not increase with concentrations of piperacillin higher than 4-6xMIC
, which means that the drug is concentration-independent in terms of its actions. Piperacillin has instead shown to offer higher bacteriocidal activity when its concentration remains above the MIC for longer periods of time (50% time>MIC showing the highest activity). This higher activity (present in continuous dosing) has not been directly linked to clinical outcomes, but however does show promise of lowering possibility of resistance and decreasing mortality.
(pneumonia
, peritonitis
), some diabetes-related foot infections
and empirical therapy in febrile neutropenia
(e.g., after chemotherapy
).
Piperacillin/tazobactam:
Beta-lactam antibiotic
β-Lactam antibiotics are a broad class of antibiotics, consisting of all antibiotic agents that contains a β-lactam nucleus in its molecular structure. This includes penicillin derivatives , cephalosporins , monobactams, and carbapenems...
antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...
of the ureidopenicillin
Ureidopenicillin
The ureidopenicillins are a group of penicillins which are active against Pseudomonas aeruginosa.There are three ureidopenicillins in clinical use:*Azlocillin*Piperacillin*Mezlocillin...
class.
It is normally used together with a beta-lactamase inhibitor
Beta-lactamase inhibitor
A beta-lactamase inhibitor is a drug given in conjunction with a beta-lactam antibiotic. Although the inhibitor does not usually have significant antibiotic activity on its own, it inhibits activity of beta-lactamase, a protein that confers resistance of beta-lactam antibiotics to...
such as tazobactam
Tazobactam
Tazobactam is a compound that inhibits the action of bacterial beta-lactamases. It is added to the extended spectrum beta-lactam antibiotic piperacillin to produce Tazocin or Zosyn or Piprataz...
. The combination drug piperacillin/tazobactam
Piperacillin/tazobactam
Piperacillin/tazobactam is a combination antibiotic containing the extended-spectrum penicillin antibiotic piperacillin and the β-lactamase inhibitor tazobactam. It is marketed as Kilbac by Morepen and Tazocin or, in the USA, as Zosyn by Wyeth Pharms Inc .-External links:*...
is commercially available as e.g. Tazocin, Zosyn, Brodactam, Piptaz and as Trezora. The combination has activity against many Gram-positive
Gram-positive
Gram-positive bacteria are those that are stained dark blue or violet by Gram staining. This is in contrast to Gram-negative bacteria, which cannot retain the crystal violet stain, instead taking up the counterstain and appearing red or pink...
and Gram-negative
Gram-negative
Gram-negative bacteria are bacteria that do not retain crystal violet dye in the Gram staining protocol. In a Gram stain test, a counterstain is added after the crystal violet, coloring all Gram-negative bacteria with a red or pink color...
pathogens and anaerobes
Anaerobic organism
An anaerobic organism or anaerobe is any organism that does not require oxygen for growth. It could possibly react negatively and may even die if oxygen is present...
, including Pseudomonas aeruginosa
Pseudomonas aeruginosa
Pseudomonas aeruginosa is a common bacterium that can cause disease in animals, including humans. It is found in soil, water, skin flora, and most man-made environments throughout the world. It thrives not only in normal atmospheres, but also in hypoxic atmospheres, and has, thus, colonized many...
.
Administration
Piperacillin is not absorbed orally, and must therefore be given by intravenousIntravenous therapy
Intravenous therapy or IV therapy is the infusion of liquid substances directly into a vein. The word intravenous simply means "within a vein". Therapies administered intravenously are often called specialty pharmaceuticals...
or intramuscular injection
Intramuscular injection
Intramuscular injection is the injection of a substance directly into a muscle. In medicine, it is one of several alternative methods for the administration of medications . It is used for particular forms of medication that are administered in small amounts...
; piperacillin/tazobactam
Piperacillin/tazobactam
Piperacillin/tazobactam is a combination antibiotic containing the extended-spectrum penicillin antibiotic piperacillin and the β-lactamase inhibitor tazobactam. It is marketed as Kilbac by Morepen and Tazocin or, in the USA, as Zosyn by Wyeth Pharms Inc .-External links:*...
is administered intravenously every 6 or 8 hours; the drug may also be given by continuous infusion. It has been shown that the bacteriocidal actions of the drug do not increase with concentrations of piperacillin higher than 4-6xMIC
Minimum inhibitory concentration
In microbiology, minimum inhibitory concentration is the lowest concentration of an antimicrobial that will inhibit the visible growth of a microorganism after overnight incubation. Minimum inhibitory concentrations are important in diagnostic laboratories to confirm resistance of microorganisms...
, which means that the drug is concentration-independent in terms of its actions. Piperacillin has instead shown to offer higher bacteriocidal activity when its concentration remains above the MIC for longer periods of time (50% time>MIC showing the highest activity). This higher activity (present in continuous dosing) has not been directly linked to clinical outcomes, but however does show promise of lowering possibility of resistance and decreasing mortality.
Uses
Its main uses are in intensive care medicineIntensive care medicine
Intensive-care medicine or critical-care medicine is a branch of medicine concerned with the diagnosis and management of life threatening conditions requiring sophisticated organ support and invasive monitoring.- Overview :...
(pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...
, peritonitis
Peritonitis
Peritonitis is an inflammation of the peritoneum, the serous membrane that lines part of the abdominal cavity and viscera. Peritonitis may be localised or generalised, and may result from infection or from a non-infectious process.-Abdominal pain and tenderness:The main manifestations of...
), some diabetes-related foot infections
Diabetic foot
Diabetic foot ulcer is one of the major complications of diabetes mellitus, and probably the major component of the diabetic foot. It occurs in 15% of all patients with diabetes and precedes 84% of all lower leg amputations...
and empirical therapy in febrile neutropenia
Neutropenia
Neutropenia, from Latin prefix neutro- and Greek suffix -πενία , is a granulocyte disorder characterized by an abnormally low number of neutrophils, the most important type of white blood cell...
(e.g., after chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....
).
Trade names and preparations
Piperacillin alone:- Piperacillin (U.S., marketed by Istituto Biochimico)
Piperacillin/tazobactam:
- Tazocin (UK, marketed by WyethWyethWyeth, formerly one of the companies owned by American Home Products Corporation , was a pharmaceutical company. The company was based in Madison, New Jersey, USA...
) - Tazocin (New Zealand, marketed by WyethWyethWyeth, formerly one of the companies owned by American Home Products Corporation , was a pharmaceutical company. The company was based in Madison, New Jersey, USA...
) - Zosyn (U.S., marketed by WyethWyethWyeth, formerly one of the companies owned by American Home Products Corporation , was a pharmaceutical company. The company was based in Madison, New Jersey, USA...
)