Piperacillin-tazobactam Intravenous Infusion for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

  • Piperacillin/Tazobactam is a Penicillin antibiotic. Enquire and clearly document the patient's allergy status prior to giving or prescribing this medicine
  • Flush the line before and after giving Piperacillin/Tazobactam, particularly where gentamicin or other aminoglycosides are concerned (in order to avoid inactivation of the aminoglycosides)
  • All brands contain Sodium (approx 10mmol per 4.5g vial)- if sodium load is important (ref 1)
  • See under 'Dose' for adjustments required in renal impairment

Available preparations

Piperacillin/Tazobactam (4g/0.5g)

Piperacillin/Tazobactam (2g/0.25g)

(Tazocin- search synonym)

Reconstitution

Sodium chloride 0.9% or Water for injection

Add 10ml to each 2.25g

Add 20ml to each 4.5g

  • Shake the vial vigorously for one to two minutes
  • The displacement value is significant - withdraw the whole volume in the vial after reconstitution for administration of the whole dose (ref 1)

Infusion fluids

Sodium chloride 0.9% or Glucose 5%

Glucose 5% may be preferred for high doses (to avoid Sodium load)

Methods of intravenous administration

Intermittent intravenous infusion

  • Add required dose to 100ml infusion fluid and administer over 30 minutes
  • To prepare infusion, attach a 100ml infusion bag to the vial using the Braun Transofix (ref 4090500) device
  • See further information re smaller volume infusions if required

Dose in adults

Neutropenic sepsis, Sepsis source unclear (ref 2), Hospital Acquired Pneumonia,

  • Give 4.5g every six hours

Other infections

  • Give 4.5g every eight hours
    Renal impairment
    eGFR (ml per minute/1.73m2) Dose Frequency
    20 to 40 4.5g Every eight hours
    less than 20 4.5g Every twelve hours
    Renal replacement therapy Consult pharmacy or specialist text

    Hepatic Impairment: No dose adjustment is necessary

    Monitoring

    • Monitor FBC, renal and hepatic function during prolonged treatment

    Further information

    • While an infusion volume of 50ml or 100ml may be used, a 100ml volume is recommended in order to reduce the amount of drug lost in the 'residual volume' of the administration set (which can be up to 20ml - ie 40% of drug lost). A smaller volume infusion of 50ml may be used, but care must be taken to flush through the drug solution remaining in the line.

    Storage

    • Store below 250C

    References

    Piperacillin/Tazobactam 4g/0.5g McDermott/Gerard Sept 2020

    1.Medusa- Injectable drugs guide, downloaded Oct 7th, 2021

    2: GAPP, July 2021

    Therapeutic classification

    Broad-spectrum antipseudomonal penicillin with beta-lacatamase inhibitor