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Piperacillin-Tazobactam Side Effects: A Comprehensive Guide to Hematologic Adverse Reactions

by alexxlab

What are the common hematologic side effects of piperacillin-tazobactam. How does piperacillin-tazobactam induce immune hemolytic anemia. What are the risk factors for developing adverse reactions to piperacillin-tazobactam. How can healthcare providers manage and prevent piperacillin-tazobactam-induced hematologic complications.

Содержание

Overview of Piperacillin-Tazobactam and Its Hematologic Side Effects

Piperacillin-tazobactam is a widely used broad-spectrum antibiotic combination that has proven effective against various bacterial infections. However, like many potent antimicrobials, it carries the risk of adverse effects, particularly those affecting the hematologic system. This article delves into the hematologic side effects associated with piperacillin-tazobactam, exploring their mechanisms, clinical presentations, and management strategies.

Hematologic adverse effects are among the most significant concerns associated with piperacillin-tazobactam therapy. These can range from mild alterations in blood cell counts to severe, life-threatening conditions such as immune hemolytic anemia. Understanding these potential complications is crucial for healthcare providers to ensure safe and effective use of this antibiotic combination.

Common Hematologic Side Effects

The most frequently reported hematologic side effects of piperacillin-tazobactam include:

  • Neutropenia
  • Thrombocytopenia
  • Anemia
  • Eosinophilia

These effects can occur in varying degrees of severity and may necessitate dose adjustments or discontinuation of the drug in some cases.

Immune Hemolytic Anemia: A Serious Complication

Immune hemolytic anemia (IHA) is a rare but potentially severe complication of piperacillin-tazobactam therapy. This condition occurs when the immune system mistakenly attacks and destroys red blood cells, leading to a rapid decrease in hemoglobin levels.

How does piperacillin-tazobactam induce immune hemolytic anemia? The mechanism involves the drug acting as a hapten, binding to proteins on the surface of red blood cells. This drug-protein complex is recognized as foreign by the immune system, triggering an antibody response. These antibodies then attack the red blood cells, causing their destruction (hemolysis).

Clinical Presentation of Immune Hemolytic Anemia

Patients developing IHA due to piperacillin-tazobactam may present with:

  • Sudden onset of fatigue and weakness
  • Shortness of breath
  • Pallor
  • Jaundice
  • Dark urine
  • Tachycardia

In severe cases, IHA can lead to life-threatening complications such as acute renal failure or cardiovascular collapse.

Risk Factors for Piperacillin-Tazobactam-Induced Hematologic Adverse Effects

Certain factors may increase the risk of developing hematologic complications from piperacillin-tazobactam therapy. These include:

  1. Prolonged duration of treatment
  2. High doses of the antibiotic
  3. Concurrent use of other myelosuppressive drugs
  4. Pre-existing hematologic disorders
  5. Advanced age
  6. Renal impairment

Patients with cystic fibrosis appear to be at a higher risk of developing immune hemolytic anemia, as evidenced by several case reports in the literature.

Diagnosis and Management of Piperacillin-Tazobactam-Induced Hematologic Complications

Early recognition and prompt management of hematologic adverse effects are crucial to prevent serious complications. Diagnosis typically involves:

  • Regular monitoring of complete blood counts
  • Peripheral blood smear examination
  • Direct antiglobulin test (DAT) in suspected cases of immune hemolytic anemia
  • Serum lactate dehydrogenase (LDH) and haptoglobin levels

How should healthcare providers manage piperacillin-tazobactam-induced hematologic complications? The primary step is often discontinuation of the offending drug. In cases of severe anemia, blood transfusions may be necessary. For immune hemolytic anemia, corticosteroids and intravenous immunoglobulin (IVIG) have shown efficacy in some cases.

Prevention Strategies

To minimize the risk of hematologic complications, healthcare providers should:

  • Conduct thorough pre-treatment evaluations
  • Implement regular monitoring of blood counts during therapy
  • Consider alternative antibiotics in high-risk patients
  • Adjust dosing in patients with renal impairment
  • Educate patients about potential signs and symptoms to report

Case Studies: Lessons from Reported Incidents

Several case reports in the literature provide valuable insights into the presentation and management of piperacillin-tazobactam-induced hematologic adverse effects. For instance, Bandara et al. reported a case of immune hemolytic anemia in an adult with cystic fibrosis, highlighting the importance of vigilance in this patient population.

Another notable case, reported by Lohiya et al., described a patient who presented with tachycardia and cardiac arrest due to piperacillin-induced immune hemolysis. This case underscores the potential severity of these reactions and the need for prompt recognition and intervention.

Alternative Antibiotics and Cross-Reactivity Concerns

In patients who have experienced hematologic adverse effects from piperacillin-tazobactam, choosing alternative antibiotics requires careful consideration. Cross-reactivity with other beta-lactam antibiotics is a concern, particularly with other penicillins.

Are there safe alternatives for patients with a history of piperacillin-tazobactam-induced hematologic reactions? While individual cases may vary, some studies have shown that certain carbapenems, such as meropenem, may be tolerated in patients with piperacillin-induced immune hemolytic anemia. However, close monitoring is essential when introducing any new antibiotic in these patients.

Desensitization Protocols

In some cases where piperacillin-tazobactam is the most appropriate antibiotic option, desensitization protocols have been attempted. These involve administering gradually increasing doses of the drug under close medical supervision. While successful in some instances, this approach carries risks and should only be considered in carefully selected cases under expert guidance.

Long-Term Implications and Follow-Up

Patients who have experienced hematologic adverse effects from piperacillin-tazobactam may require long-term follow-up. This is particularly important for those who have developed immune hemolytic anemia, as there is a risk of recurrence with re-exposure to the drug or related compounds.

Long-term monitoring may include:

  • Regular blood count checks
  • Periodic assessment of organ function, especially renal function
  • Screening for potential late complications
  • Counseling on avoiding potential cross-reactive medications

Healthcare providers should also ensure that patients have appropriate documentation of their adverse reaction to prevent inadvertent re-exposure in future healthcare encounters.

Future Directions in Research and Clinical Practice

As our understanding of drug-induced hematologic adverse effects continues to evolve, several areas warrant further investigation:

  1. Genetic factors predisposing individuals to piperacillin-tazobactam-induced hematologic reactions
  2. Development of rapid diagnostic tests for early detection of immune-mediated reactions
  3. Novel therapeutic approaches for managing severe cases of drug-induced immune hemolytic anemia
  4. Refinement of desensitization protocols to improve safety and efficacy
  5. Exploration of potential protective strategies to prevent hematologic complications in high-risk patients

Ongoing research in these areas may lead to improved risk stratification, earlier detection, and more effective management strategies for patients receiving piperacillin-tazobactam therapy.

Pharmacovigilance and Reporting

The importance of vigilant monitoring and reporting of adverse drug reactions cannot be overstated. Healthcare providers play a crucial role in contributing to our collective knowledge by reporting suspected cases of piperacillin-tazobactam-induced hematologic adverse effects to relevant pharmacovigilance databases.

How can healthcare providers contribute to improving drug safety? By thoroughly documenting and reporting adverse reactions, including detailed clinical information, laboratory findings, and patient outcomes. This data is invaluable for ongoing safety assessments and the development of evidence-based guidelines for antibiotic use.

Patient Education and Informed Decision-Making

Effective communication with patients about the potential risks and benefits of piperacillin-tazobactam therapy is essential. Healthcare providers should engage patients in informed decision-making, providing clear information about:

  • The purpose of the antibiotic treatment
  • Potential side effects, including hematologic complications
  • Signs and symptoms that warrant immediate medical attention
  • The importance of adherence to monitoring protocols
  • Alternative treatment options, if applicable

Empowering patients with knowledge can lead to earlier recognition of adverse effects and improved overall outcomes.

Special Considerations for Vulnerable Populations

Certain patient groups may require special consideration when prescribing piperacillin-tazobactam:

  • Elderly patients: May have reduced renal function and be more susceptible to adverse effects
  • Patients with cystic fibrosis: Higher risk of immune hemolytic anemia
  • Critically ill patients: May have altered drug metabolism and increased risk of complications
  • Patients with pre-existing hematologic disorders: Require careful monitoring and dose adjustment

Tailoring treatment approaches to these vulnerable populations can help minimize the risk of hematologic complications while ensuring effective antimicrobial therapy.

In conclusion, while piperacillin-tazobactam remains a valuable antibiotic in the treatment of serious infections, awareness of its potential hematologic side effects is crucial for safe and effective use. Through vigilant monitoring, prompt recognition of adverse effects, and appropriate management strategies, healthcare providers can optimize patient outcomes and minimize the risk of serious complications. Ongoing research and pharmacovigilance efforts will continue to refine our understanding and management of these important drug-related adverse events.

Hematologic adverse effects induced by piperacillin–tazobactam: a systematic review of case reports

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    Adult Medication

    This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

    Brand Names: US

    Zosyn

    What is this drug used for?

    • It is used to treat bacterial infections.

    What do I need to tell my doctor BEFORE I take this drug?

    • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
    • If you are taking probenecid.

    This is not a list of all drugs or health problems that interact with this drug.

    Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

    What are some things I need to know or do while I take this drug?

    • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
    • Have blood work checked as you have been told by the doctor. Talk with the doctor.
    • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
    • If you have high blood sugar (diabetes) and test your urine glucose, talk with your doctor to find out which tests are best to use.
    • Do not use longer than you have been told. A second infection may happen.
    • If you are on a low-sodium or sodium-free diet, talk with your doctor. Some of these products have sodium.
    • This drug may cause muscle twitching or seizures in some people. The risk may be raised if you have had seizures. The risk may also be raised with higher doses, especially in people with kidney problems. Tell your doctor if you have kidney problems or if you have had seizures.
    • If you are 65 or older, use this drug with care. You could have more side effects.
    • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

    What are some side effects that I need to call my doctor about right away?

    WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

    • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat. Rarely, some allergic reactions have been deadly.
    • Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
    • Seizures.
    • Muscle twitching, cramps, stiffness, or weakness.
    • Diarrhea is common with antibiotics. Rarely, a severe form called C diff–associated diarrhea (CDAD) may happen. Sometimes, this has led to a deadly bowel problem. CDAD may happen during or a few months after taking antibiotics. Call your doctor right away if you have stomach pain, cramps, or very loose, watery, or bloody stools. Check with your doctor before treating diarrhea.
    • Severe skin reactions may happen with this drug. These include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious reactions. Sometimes, body organs may also be affected. These reactions can be deadly. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin; red or irritated eyes; sores in your mouth, throat, nose, eyes, genitals, or any areas of skin; fever; chills; body aches; shortness of breath; or swollen glands.
    • Rarely, low blood cell counts have happened with this drug. Call your doctor right away if you have any unexplained bruising or bleeding; signs of infection like fever, chills, or sore throat; or feel very tired or weak.
    • An immune system problem called hemophagocytic lymphohistiocytosis (HLH) has happened with this drug. Call your doctor right away if you have a fever, swollen gland, rash, or swelling in the stomach area or severe stomach pain.

    What are some other side effects of this drug?

    All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

    • Headache.
    • Upset stomach.
    • Diarrhea or constipation.
    • Trouble sleeping.

    These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

    You may report side effects to your national health agency.

    You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www. fda.gov/medwatch.

    How is this drug best taken?

    Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

    • It is given as an infusion into a vein over a period of time.

    What do I do if I miss a dose?

    • Call your doctor to find out what to do.

    How do I store and/or throw out this drug?

    • If you need to store this drug at home, talk with your doctor, nurse, or pharmacist about how to store it.

    General drug facts

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else’s drugs.
    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
    • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
    • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

    Consumer Information Use and Disclaimer

    This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

    Last Reviewed Date

    2023-01-11

    Copyright

    © 2023 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

    Last Updated

    Monday, December 12, 2022

    Tazobactam (tazobactam): description, use, side effects

    Tazobactam (tazobactam) is a powerful inhibitor of beta-lactamase, which is often used in combination with the antibiotic piperacillin to fight certain types of bacteria. This drug is widely used in medical practice to treat infections caused by strains of bacteria resistant to other antibiotics. Learn more about the uses and side effects of tazobactam.

    Tazobactam is a beta-lactamase inhibitor antibiotic used in combination with other antibiotics to treat various infections. It has high activity against a wide range of bacteria, including many types of gram-positive and gram-negative microorganisms.

    Tazobactam is especially effective when the infection is caused by bacteria that are resistant to other antibiotics. It is often used in the treatment of infections of the urinary tract, gastrointestinal tract, skin and soft tissues, lungs and other organs.

    It should be noted that tazobactam is a prescription drug and should only be used as directed by a physician. Taking tazobactam can cause a variety of side effects, including injection site reactions, allergic reactions, diarrhea, nausea, and vomiting. If any unwanted symptoms appear, you should immediately consult a doctor.

    In general, tazobactam is an important antibiotic that helps fight infections caused by drug-resistant bacteria. However, its use must be conscious and controlled by the doctor in order to avoid possible side effects and the development of bacterial resistance to this drug.

    What is tazobactam?

    Tazobactam is a drug that belongs to the class of beta-lactamase inhibitors. It is used in combination with the antibiotic piperacillin to treat infections caused by bacteria that produce beta-lactamase, such as gram-negative bacteria.

    Tazobactam works by interfering with the action of beta-lactamases, an enzyme that breaks down beta-lactam antibiotics, rendering them ineffective. This allows piperacillin to be active and fight infection.

    Tazobactam is available as a powder for solution for injection. It is commonly used in a hospital setting and can be used to treat urinary tract infections, bronchitis, pneumonia, acute sinusitis, and other infections caused by piperacillin-susceptible organisms.

    Tazobactam is generally well tolerated by patients, but side effects such as diarrhea, nausea, vomiting, allergic reactions and changes in liver enzymes are possible. Before using tazobactam, you should consult with your doctor and read the instructions for use.

    Primary use of tazobactam

    Tazobactam is a beta-lactamase inhibitor used in combination with antibiotics to fight infections caused by Gram-negative bacteria. The main use of tazobactam is associated with its ability to enhance the activity of antibiotics and prevent their destruction by beta-lactamases.

    Tazobactam is widely used in clinical practice for the treatment of urinary tract infections, bronchitis, pneumonia, acute abdominal infections and other infections caused by gram-negative bacteria, including various strains of E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and others.

    Preparations containing tazobactam can be used in both inpatient and outpatient settings. They have a wide spectrum of activity and can be effective for various types of infections. However, before starting the use of tazobactam, it is necessary to conduct an antibiogram to determine the sensitivity of the pathogen to this drug.

    Positive

    0%

    Negative

    0%

    Neutral

    0%

    How does tazobactam work?

    Tazobactam is a beta-lactamase inhibitor, which means that it blocks the activity of enzymes that break down beta-lactam antibiotics. Thus, tazobactam enhances the action of antibiotics and allows them to effectively fight infection.

    Tazobactam is broad spectrum active against many Gram positive and Gram negative bacteria including Staphylococcus, Streptococcus, Escherichia, Escherichia coli, Proteus and Pseudomonas.

    In combination with antibiotics such as piperacillin or ceftazidime, tazobactam exhibits a synergistic effect, meaning that its presence enhances the bactericidal action of the antibiotic. It is especially useful in treating infections caused by beta-lactamase producing bacteria.

    Tazobactam is usually used in combination with other antibiotics to treat serious infections such as pneumonia, sepsis, and urinary tract infections. It can be used as an injection or intravenous injection. The dosage and duration of treatment depend on the type of infection and the patient’s response to the drug.

    How to take tazobactam?

    Tazobactam is an antibiotic used in combination with other drugs to treat infections. The dosage and route of administration of tazobactam should be determined by the physician, depending on the type of infection, its severity, and the individual patient.

    Tazobactam is usually taken intravenously, that is, injected directly into a vein. The frequency and duration of administration may vary depending on the specific situation, but usually the drug is used every 6-8 hours. It is important to observe the regularity of taking and not to miss the prescribed doses.

    The dosage of tazobactam may vary depending on the age and weight of the patient and the type of infection. To determine the optimal dose, you should consult a doctor or read the instructions for the drug.

    It is important to remember that self-medication with tazobactam is unacceptable. The drug must be prescribed and monitored by a doctor who will monitor the effectiveness of treatment and possible side effects.

    What are the possible side effects of taking tazobactam?

    Tazobactam is an antibiotic that can cause various side effects in patients. Some of these may be mild and temporary, while others may be more severe and require medical attention.

    One of the most common side effects of tazobactam is diarrhea. Patients may experience frequent and loose stools, which can lead to dehydration. In the event of diarrhea, a doctor should be consulted for advice and possible treatment.

    Another side effect associated with taking tazobactam is an allergic reaction. Patients may experience itching, rash, swelling of the face, throat, or tongue. In the event of an allergic reaction, you should immediately consult a doctor or call an ambulance.

    Tazobactam can also cause digestive problems such as nausea and vomiting. These symptoms may be temporary and disappear after the end of the drug. However, if nausea and vomiting persist or worsen, a doctor should be consulted.

    Other possible side effects of tazobactam include headache, bone marrow depression, increased sensitivity to sunlight, elevated liver enzymes, and changes in blood pressure. If you experience these or any other unusual symptoms, be sure to tell your doctor.

    In general, tazobactam is an effective medicine, but like all medicines, it can cause side effects. Patients should be attentive to their condition and consult a doctor in case of any unusual symptoms or complications.

    What are the contraindications for tazobactam?

    Tazobactam is a powerful antibiotic, but it also has some contraindications that must be taken into account when using it.

    First of all, tazobactam is contraindicated in people with a known allergy to this drug or to other beta-lactam antibiotics such as penicillins or cephalosporins. An allergic reaction to tazobactam can cause hives, laryngeal edema, or even anaphylactic shock, so it is important to be careful when prescribing this drug to a patient.

    In addition, tazobactam is not recommended if you have a history of serious side effects with this antibiotic, such as seizures or impaired kidney function. In such cases, the use of tazobactam can be dangerous and requires special care.

    Tazobactam is also not recommended for pregnant women, especially in the first trimester of pregnancy, as its safety to the fetus has not been established. However, if it is necessary to use tazobactam in pregnant women, the doctor may decide on its use, taking into account the benefit to the mother and the potential risk to the fetus.

    It is also important to consider possible interactions of tazobactam with other drugs. For example, some antibiotics may increase its effect, while others may decrease its effectiveness. Therefore, before using tazobactam, it is necessary to consult a doctor and inform him about all the medicines taken.

    Interactions of tazobactam with other drugs

    Tazobactam may interact with some drugs, which may lead to a change in their effectiveness or side effects. Before starting treatment with tazobactam, tell your doctor about all medications you are taking, including prescription, over-the-counter, and herbal medications.

    Simultaneous use of tazobactam with aminoglycosides such as gentamicin or tobramycin may increase their toxic effects on the kidneys and hearing. Therefore, the doctor may decide to reduce the dose of aminoglycosides or prescribe other antibiotics.

    Tazobactam may increase the concentration of methotrexate in the blood, which may increase the risk of its toxic effects. With the simultaneous use of these drugs, it is necessary to carefully monitor the level of methotrexate in the body and, if necessary, adjust its dose.

    Antifungal drugs such as fluconazole or voriconazole may increase the blood concentration of tazobactam, which may increase its action and cause side effects. With the simultaneous use of these drugs, it is necessary to carefully monitor the patient’s condition and, if necessary, adjust the dose of tazobactam.

    Tazobactam may increase the effect of anticoagulants such as warfarin, which may lead to increased clotting time and risk of bleeding. With the simultaneous use of these drugs, it is necessary to carefully monitor the state of blood clotting and, if necessary, adjust the dose of anticoagulants.

    Q&A:

    What is tazobactam?

    Tazobactam is an antibiotic used in combination with other drugs to treat infections. It belongs to the class of beta-lactamase inhibitors, which help protect antibiotics from being destroyed by bacteria.

    How is tazobactam used?

    Tazobactam is used with other antibiotics to treat infections caused by bacteria that are resistant to other antibiotics. It can be given intravenously, usually in a hospital setting.

    What infections can be treated with tazobactam?

    Tazobactam is used to treat various infections such as urinary tract infections, lung infections, skin and soft tissue infections, abdominal infections, and others. However, it is not effective against viral infections such as the flu or the common cold.

    What side effects can tazobactam cause?

    Tazobactam can cause various side effects, including allergic reactions, diarrhea, nausea, vomiting, headache, elevated liver enzymes, etc. If you experience any side effects while using tazobactam, you should consult your doctor.

    What preparations contain tazobactam?

    Tazobactam is found in various combination products, such as Tazocin, Timentin, etc. They combine tazobactam with other antibiotics to enhance the effect of treating infections.

    Can tazobactam be used during pregnancy?

    The use of tazobactam during pregnancy may not be safe for the baby. Therefore, before using this drug, it is necessary to consult a doctor and weigh the benefits and risks.

    How long should I take tazobactam?

    How long you take tazobactam depends on the type and severity of the infection and your doctor’s advice. The drug is usually taken over several days to several weeks. It is important to take the drug in accordance with the doctor’s prescription and not stop taking it earlier than the specified period.

    Important information about tazobactam

    Tazobactam is a medicine used in combination with antibiotics to treat infections caused by bacteria that are usually resistant to other antibiotics.

    Tazobactam belongs to a class of beta-lactamase inhibitors that prevent the destruction of antibiotics by bacterial enzymes. This allows you to enhance the effectiveness of antibiotics and fight infection more effectively.

    The use of tazobactam is especially important in cases where bacteria are resistant to other antibiotics. It is widely used to treat urinary tract infections, bronchitis, pneumonia, and skin and soft tissue infections.

    Tazobactam is usually given intravenously as an injection or infusion. The dosage and duration of treatment are determined by the doctor depending on the type of infection, its severity and other factors.

    Side effects such as allergic reactions, diarrhea, nausea, vomiting, headache and increased liver activity may occur when using tazobactam. If you experience any unusual symptoms or side effects, contact your doctor.

    It is important to remember that tazobactam is a prescription drug and should only be used with a doctor’s prescription. It is not recommended to self-medicate or change the dosage without consulting a medical professional.

    Related video:

    instructions for use, analogues, articles

    Piperacillin is a semi-synthetic broad spectrum bactericidal antibiotic. The mechanism of action is based on inhibition of the synthesis of the bacterial cell wall membrane.

    Tazobactam is a sulfonic derivative of triazolmethylpenicillanic acid. The mechanism of action is the inhibition of many beta-lactamases, including plasmid and chromosomal beta-lactamases, which cause bacterial resistance to penicillins and cephalosporins. Tazobactam significantly enhances antimicrobial activity and expands the spectrum of antibiotic action.

    The preparation is active against the following Gram-negative bacteria:

    Escherichia coli, Citrobacter spp. (including Citrobacter freundii, Citrobacter diversus), Klebsiella spp. (including Klebsiella oxytoca, Klebsiella pneumoniae), Enterobacter spp. (including Enterobacter cloaca, Enterobacter aerogenes), Proteus vulgaris, Proteus mirabilis, Providencia rettgery, Providencia stuartii, Plesiomonas shigelloides, Morganella morganii, Serratia spp. (including Serratia marcescens, Serratia liquifaciens), Salmonella spp. , Shigella spp., Pseudomonas aeruginosa and other Pseudomonas spp. (including Pseudomonas cepacia, Pseudomonas fluorescens), Xanthamonas maltophilia, Neisseria gonorrhoeae, Neisseria meningitidis, Moraxella spp. (including Branhamella catarrhalis), Acinetobacter spp., Haemophilus influenzae, Haemophilus parainfluenza, Pasteurella multocida, Yersinia spp., Campylobacter spp., Gardnerella vaginalis.

    The drug effectively affects the following strains of gram-positive bacteria:

    Streptococcus spp. (including Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus bovis, Streptococcus agalactiae, Streptococcus spp. viridans groups C and G subgroups), Enterococcus spp. (Enterococcus faecalis, Enterococcus faecium), Staphylococcus aureus (methicillin sensitive), Staphylococcus saprophyticus, Staphylococcus epidermidis (coagulase negative), Listeria monocytogenes, Nocardia spp.

    The preparation is also active against anaerobic bacteria:

    Bacteroides spp. (Bacteroides bivius, Bacteroides disiens, Bacteroides capillosus, Bacteroides melaninogenicus, Bacteroides oralis), subgroups of Bacteroides fragilis eptostreptococcus spp., Fusobacterium spp. ., Eubacterium spp., Clostridium spp. (including Clostridium difficile, Clostridium perfringens), Veilonella spp. and Actynomyces spp.

    Pharmacokinetics:

    With intravenous administration of the drug, the maximum concentration is reached immediately. Communication with plasma proteins of piperacillin and tazobactam is the same – 30%, distribution in tissues is 50-100% of plasma concentration. The drug is found in many body fluids and tissues: intestinal mucosa, gallbladder, bile, lungs, uterus, ovaries, fallopian tubes, bones.

    Piperacillin is metabolized to an inactive desmethyl metabolite, tazobactam to an inactive metabolite.

    The drug is excreted mainly by the kidneys. The half-life is 0.7-1.2 hours, with a decrease in creatinine clearance, it increases.

    Infections of the lower respiratory tract, urinary tract, skin and soft tissues, bones and joints, intraabdobinal, gynecological, mixed infections, septicemia, bacterial infections with neutropenia (in combination with aminoglycosides)

    • Hypersensitivity to beta-lactam antibiotics
    • Hypersensitivity to beta-lactamase inhibitors
    • Children under 2 years old
    • Lactation

    Caution:

    • Childhood
    • Pregnancy
    • Bleeding, including history
    • Cystic fibrosis (risk of hyperthermia)
    • Pseudomembranous colitis
    • Chronic renal failure
    • Concomitant use of anticoagulants
    • Hypokalemia

    The drug is administered intravenously by stream over 3-4 minutes or by drip over 30 minutes.

    For adults and children over 12 years of age with normal renal function, the dose is 4.5 g (4 g piperacillin/0.5 g tazobactam) every 8 hours.

    For the treatment of children 2 to 12 years of age with neutropenia, the dose is calculated based on body weight: 90 mg (80 mg piperacillin/10 mg tazobactam) per 1 kg of body weight. The drug is administered every 6 hours in combination with an appropriate dose of aminoglycoside.

    For patients on hemodialysis, the daily dose of the drug should not exceed 8 g of piperacillin / 1 g of tazobactam.

    Treatment should be carried out for at least 5 days, but not more than 14 days.

    • Allergic reactions, including anaphylactic shock
    • Abdominal pain, nausea, vomiting, dyspepsia
    • Hepatitis, jaundice
    • Stomatitis
    • Bleeding
    • Interstitial nephritis, renal failure
    • Headache, insomnia, convulsions
    • Lowering blood pressure, “hot flashes”
    • On the part of laboratory parameters: hypokalemia, transient leukopenia, eosinophilia, thrombocytopenia, positive Coombs reaction, transient increase in liver transaminases and alkaline phosphatase.
    • Local reactions (phlebitis, thrombophlebitis, redness and induration at the injection site)
    • Fungal superinfections

    Co-administration with probenecid increases the half-life of piperacillin and tazobactam.

    Co-administration with vecuronium bromide may result in more prolonged neuromuscular blockade.

    The use of high doses of heparin, indirect anticoagulants increases the risk of bleeding.

    Piperacillin delays the excretion of methotrexate from the body, which may increase its toxic effect.

    The drug should not be mixed in the same syringe or dropper with other drugs.

    Do not add to sodium bicarbonate solution or to blood or serum preparations.

    Pregnancy and lactation

    Piperacillin and tazobactam penetrate the placental barrier, so the drug is prescribed only if the expected benefit to the mother outweighs the possible risk to the fetus.

    Piperacillin is secreted in breast milk, therefore it is necessary to stop breastfeeding during the period of treatment with the drug.