KEY POINTS
- Piperacillin-tazobactam (Zosyn) is the combination of ureidopenicillin piperacillin PLUS beta-lactamase inhibitor tazobactam
- Inhibits cell wall synthesis in susceptible organisms via binding to penicillin-binding-proteins (PBPs)
- Has activity versus a wide variety of bacteria, including Gram positives, Gram negatives and anaerobes
- Has activity versus Pseudomonas aeruginosa
- DOES NOT have activity versus MRSA
- Has a wide array of uses, including for respiratory, skin, abdominal, bloodstream and other infection types
- Is a common drug started as “empiric therapy” before an organism is isolated and sensitivities are known
- Look to de-escalate from this broad-spectrum agent after 48-72 hours of empiric therapy
- Is a common drug started as “empiric therapy” before an organism is isolated and sensitivities are known
- Many institutions give it via extended infusion, over 3 or 4 hours
- It is a time-dependent killer, so the longer the time the concentration at the site of infection is above the minimum inhibitory concentration of the organism, the more killing is achieved during the dosing interval, which may translate to a better clinical outcome
- Some recent data suggests increased risk of kidney toxicity when piperacillin-tazobactam is used in combination with vancomycin
RESOURCES
- Piperacillin-tazobactam Package Insert
- IDSA Practice Guidelines
- Insights On Extend-Infusion Beta-Lactam Dosing (2016)
- Nebraska Antimicrobial Stewardship Program Piperacillin-Tazobactam Extended Infusion
- Jackson Memorial Antimicrobial Stewardship Program Piperacillin-Tazobactam Extended Infusion