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
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
