Brands, Medical Use, Clinical Data
Drug Category
- Anti-bacterial Agents
- Penicillins
Dosage Forms
Brands / Synonyms
Piperacillin and Tazobactam; Piperacillin Anhydrous; Pipracil; Pipracil
; Zosyn
Indications
For the treatment of polymicrobial infections.
Pharmacology
Piperacillin is a penicillin beta-lactam antibiotic used in the treatment of bacterial infections caused by susceptible, usually gram-positive, organisms. The name "penicillin" can either refer to several variants of penicillin available, or to the group of antibiotics derived from the penicillins. Piperacillin has in vitro activity against gram-positive and gram-negative aerobic and anaerobic bacteria. The bactericidal activity of Piperacillin results from the inhibition of cell wall synthesis and is mediated through Piperacillin binding to penicillin binding proteins (PBPs). Piperacillin is stable against hydrolysis by a variety of beta-lactamases, including penicillinases, and cephalosporinases and extended spectrum beta-lactamases.
Mechanism of Action
By binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, Piperacillin inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins; it is possible that Piperacillin interferes with an autolysin inhibitor.
Absorption
Not Available
Toxicity
Not Available
Biotrnasformation / Drug Metabolism
Not Available
Contraindications
PIPRACIL is contraindicated in patients with a history of allergic reactions to any of the
betalactams, including penicillins and/or cephalosporins.
Drug Interactions
Aminoglycosides
The mixing of piperacillin with an aminoglycoside in vitro can result in substantial
inactivation of the aminoglycoside.
Vecuronium
When used in the perioperative period, piperacillin has been implicated in the prolongation of the
neuromuscular blockade of vecuronium. Caution is indicated when piperacillin is used perioperatively. In one
controlled clinical study, the ureidopenicillins, including piperacillin, were reported to prolong the action of
vecuronium. Due to their similar mechanism of action, it is expected that the neuromuscular blockade produced by any
of the non-depolarizing muscle relaxants could be prolonged in the presence of piperacillin.
Probenecid
The oral combination of probenecid before intramuscular injection of PIPRACIL produces an increase in
piperacillin peak serum level of about 30%.
Anticoagulants
Coagulation parameters should be tested more frequently and monitored regularly during simultaneous
administration of high doses of heparin, oral anticoagulants, or other drugs that may affect the blood coagulation
system or the thrombocyte function.
Methotrexate
Piperacillin sodium may reduce the excretion of methotrexate. Therefore, serum levels of methotrexate
should be monitored in patients to avoid drug toxicity.
Drug/Laboratory Test Interactions
As with other penicillins, the administration of PIPRACIL may result in a false-positive reaction for
glucose in the urine using a copper-reduction method. It is recommended that glucose tests based on enzymatic glucose
oxidase reactions be used.
There have been reports of positive test results using the Bio-Rad Laboratories Platelia
Aspergillus EIA test in patients receiving piperacillin/tazobactam injection who were subsequently found to be
free of Aspergillus infection. Cross-reactions with non-Aspergillus polysaccharides and polyfuranoses
with the Bio-Rad Laboratories Platelia Aspergillus EIA test have been reported.
Therefore, positive test results in patients receiving piperacillin should be interpreted cautiously
and confirmed by other diagnostic methods.
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