Penicillin類抗生素

Intra-abdominal infections: Treatment of appendicitis complicated by rupture or abscess and peritonitis in adults and pediatric patients ≥2 months of age caused by beta-lactamase-producing strains of E. coli, Bacteroides fragilis, Bacteroides ovatus, Bacteroides thetaiotaomicron, or Bacteroides vulgatus
Pelvic infections: Treatment of postpartum endometritis or pelvic inflammatory disease in adults caused by beta-lactamase-producing strains of E. coli
Pneumonia, community-acquired: Moderate to severity CAP in adults caused by beta-lactamase-producing strains of H. influenzae
Pneumonia, hospital-acquired (nosocomial): Moderate to severe HAP in adults and pediatric patients ≥2 months of age caused by beta-lactamase-producing strains of S. aureus and by piperacillin/tazobactam-susceptible Acinetobacter baumannii, H. influenzae, K. pneumoniae, and P. aeruginosa
Skin and skin structure infections: Including cellulitis, cutaneous abscesses, and ischemic/diabetic foot infections in adults caused by beta-lactamase-producing strains of S. aureus

Antibiotic, Penicillin
Piperacillin inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis.
Tazobactam inhibits many beta-lactamases.

Patients with a prior history of hypersensitivity to beta-lactam antibiotics or to beta-lactamase inhibitors.

B

Women who are breast feeding should be treated only if the expected benefit outweighs the possible risks.

GI effects (diarrhea, nausea, constipation), headache, dermatologic reactions (rash, pruritus, fever), leukopenia and neutropenia

Usual dosage range:
Traditional infusion method (IV over 30 minutes)
1. Mild to moderate infections: 3.375 g every 6 hours
2. Severe infections: 4.5 g every 6 to 8 hours
3. For coverage of Pseudomonas aeruginosa: 4.5 g every 6 hours; maximum 18 g/day
Intra-abdominal infections:
1. Cholecystitis, acute: (IV) 3.375 g or 4.5 g every 6 hours; continue for 1 day after gallbladder removal or until clinical resolution in patients managed nonoperatively
2. Other intra-abdominal infection: (IV) 3.375 g or 4.5 g every 6 hours for 4 to 5 days; for diverticulitis or uncomplicated appendicitis managed without intervention, duration is 7 to 10 days
Skin and skin structure infections:
(IV) 3.375 g every 6 hours or 4.5 g every 8 hours as part of an appropriate combination regimen for 10-14 days; for treatment of P. aeruginosa, 4.5 g every 6 hours

General dosing:
1. Infants <2 months: (IV) 240 to 300 mg piperacillin/kg/day divided in 3 to 4 doses; maximum 16 g/day; some experts have recommended 80 mg piperacillin/kg/dose Q4H
2. Infants ≥2 months, Children, and Adolescents: (IV) 240 to 300 mg piperacillin/kg/day divided in 3 to 4 doses; maximum 16 g/day
Appendicitis and/or peritonitis:
1. Infants 2 to 9 months: 80 mg of piperacillin/kg/dose Q8H
2. >9 months and weigh ≤40 kg: 100 mg piperacillin/kg/dose Q8H; maximum 3,000 mg piperacillin/dose
3. weighing >40 kg: 3,000 mg piperacillin Q6H maximum 16 g piperacillin/day
Nosocomial pneumonia:
1. Infants 2 to 9 months: 80 mg piperacillin/kg/dose Q6H
2. >9 months and weigh ≤40 kg: 100 mg piperacillin/kg/dose Q6H; maximum 4,000 mg piperacillin/dose
3. weighing >40 kg: 4,000 mg piperacillin Q6H; maximum 16 g piperacillin/day

No dosage adjustment necessary.