Drug reference

Piperacillin-Tazobactam

Penicillin · Antibiotic

Also known as Pip-Taz, Piptazobactam, Piptaz

PenicillinAntibiotic

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

FDA category + note

Mechanism

Piperacillin, an extended-spectrum penicillin, inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to bacterial lysis. Tazobactam is a beta-lactamase inhibitor that irreversibly binds to and inactivates a wide range of bacterial beta-lactamases, protecting piperacillin from enzymatic degradation and extending its antibacterial spectrum. This combination enhances bactericidal activity against many resistant strains.

Indications

Complicated intra-abdominal infectionsComplicated skin and skin structure infectionsCommunity-acquired pneumoniaHospital-acquired pneumonia (including ventilator-associated pneumonia)Urinary tract infections (complicated)Pelvic inflammatory diseaseFebrile neutropenia (empiric therapy)Diabetic foot infections (off-label)

Dosing

Adult: Standard: 3.375g IV every 6 hours (infused over 30 minutes) or 4.5g IV every 8 hours. For severe hospital-acquired pneumonia/VAP: 4.5g IV every 6 hours (extended infusion over 3-4 hours often recommended).
Pediatric: For >= 2 months and < 40 kg: 90 mg/kg (piperacillin 80 mg/kg / tazobactam 10 mg/kg) IV every 6-8 hours, not to exceed 4.5g per dose. For >= 40 kg: Adult dosing.
Renal adjustment: CrCl > 40 mL/min: No adjustment. CrCl 20-40 mL/min: 3.375 g IV every 8 hours. CrCl < 20 mL/min: 2.25 g IV every 8 hours. Hemodialysis: 2.25 g IV every 12 hours, with an additional 0.75 g dose after each dialysis session. CRRT: Dosing is highly variable and requires individualized adjustment based on modality and intensity.…

Pharmacokinetics

Onset

Rapid (due to IV administration)

Peak effect

End of infusion

Protein binding

Piperacillin: ~21-25%; Tazobactam: ~30%

Contraindications

Hypersensitivity to piperacillin, tazobactam, other penicillins, or any beta-lactam antibacterial agents
History of severe allergic reaction to any beta-lactam

Side effects

Common

DiarrheaNauseaVomitingRashHeadacheConstipationInsomniaDyspepsiaPruritusFeverGastrointestinal side effects (e.g., diarrhea)

Serious

Anaphylaxis and other severe hypersensitivity reactions (e.g., Stevens-Johnson syndrome, toxic epidermal necrolysis)
Clostridioides difficile-associated diarrhea (CDAD)
Neutropenia
Thrombocytopenia
Leukopenia
Seizures (especially with high doses in renally impaired patients)
Interstitial nephritis
Cholestatic hepatitis
Prolonged prothrombin time/INR (especially in patients with renal impairment, vitamin K deficiency, or on anticoagulants)
Hypersensitivity reactions (rash to anaphylaxis)
Serum sickness
Stevens-Johnson syndrome
Nephropathy
Hematologic reactions (neutropenia, prolonged use)
Neurotoxicity (seizure, high doses, renal impairment)