Piperacillin/Tazobactam: A New Beta-Lactam/Beta-Lactamase Inhibitor Combination

Schoonover, Lori L.; Occhipinti, Donna J.; Rodvold, Keith A.; Danziger, Larry H.

doi:10.1177/106002809502900510

Cited by 45 publications

(25 citation statements)

References 26 publications

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“…In our study, the proportion of patients treated for bone-related infections with piperacillin-tazobactam who developed reversible neutropenia was high. Reviews of this antibiotic do not mention this side-effect, although they do describe its efficacy in long-term treatment of osteomyelitis [3][4][5]. Moreover, in a recent review of 21 cases of antibiotic-induced agranulocytosis, none of the cases reviewed were related to piperacillintazobactam therapy [14].…”

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confidence: 97%

“…However, the length of piperacillin-tazobactam treatment described in published studies does not usually surpass 2 weeks [3][4][5], including some recent trials dealing with patients with diabetic foot infection [19,20]. Ruiz-Irastorza et al [18] explain these apparent differences in the marrow toxicity of piperacillin and piperacillin-tazobactam by the difference in the amount of the usual daily dose (12 g, in the case of piperacillin, and 16 g, in the case of piperacillin-tazobactam).…”

mentioning

confidence: 99%

“…Piperacillintazobactam, a combination of a semisynthetic ureidopenicillin and a b-lactamase inhibitor, has broad-spectrum activity and is useful in treating polymicrobial and gram-negative bacterial infections [2][3][4], including diabetic foot infections [5] and osteomyelitis [1, 6]. b-Lactam antibiotics, in general [7-11], and piperacillin [9] and piperacillin-tazobactam, in particular [10], can lead to reversible neutropenia in patients receiving treatments lasting 110 days [11].…”

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confidence: 99%

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Incidence of Neutropenia during Treatment of Bone-Related Infections with Piperacillin-Tazobactam

Peralta

Sánchez

Roiz

et al. 2003

Clinical Infectious Diseases

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Of 41 patients with bone-related infections who were treated for > or =10 days with piperacillin-tazobactam, 14 (34%) developed neutropenia. Cumulative doses of piperacillin administered to neutropenic patients were higher than those administered to nonneutropenic ones (330 vs. 237 g; P=.008), and an inverse correlation was detected between the absolute neutrophil count at the end of treatment and the cumulative dose of piperacillin (r=-0.47, P=.002). Moreover, the incidence of piperacillin-tazobactam-induced neutropenia increased with an increase in the cumulative dose of piperacillin: 0% of patients in the first quartile of cumulative piperacillin doses, 33.3% in the second quartile, 40% in the third quartile, and 66.7% in the fourth quartile.

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confidence: 97%

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confidence: 99%

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confidence: 99%

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Incidence of Neutropenia during Treatment of Bone-Related Infections with Piperacillin-Tazobactam

Peralta

Sánchez

Roiz

et al. 2003

Clinical Infectious Diseases

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“…The standard dose of piperacillin/tazobactam is 3.375 g (3 g of with piperacillin/tazobactam treatment than with other combination antibiotic therapies. 11 The most piperacillin and 0.375 g of tazobactam) administered q 6 h. 1 After the dosing of 3 g of piperacillin common laboratory abnormalities have been related to hepatic function: a 1.1% increase in total bilirubin and 0.375 g of tazobactam over 5 min, the maximum concentration (C max ) (mg/l) is 336 with an area under levels and a 5.6% increase in alanine aminotransferase levels. 11 The incidence of elevations increased the curve (AUC) of 230; Cl T is 219; and 51.7% is excreted in the urine.…”

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confidence: 99%

Piperacillin/Tazobactam (ZOSYN)

Culver

Martens

1996

Infectious Diseases in Obstetrics and Gynecology

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“…Ureidopenicillins are not stable against beta‐lactamases and therefore lack activity against some important pathogens such as Staphylococcus aureus and TEM‐type‐beta‐lactamase producing gram‐negative rods. Pip–Tazo is a combination of the ureidopenicillin with broadest spectrum of activity and a beta‐lactamase inhibitor and has excellent activity against gram‐positive, gram‐negative, and anaerobic bacteria (1, 2). The broad spectrum of activity enables the application as a single agent and the low toxicity favors Pip–Tazo also in critical situations.…”

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confidence: 99%

Experience with the use of piperacillin–tazobactam in pediatric non‐renal solid organ transplantation

Wiesmayr¹,

Stelzmueller²,

Märk³

et al. 2006

Pediatric Transplantation

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Bacterial infection remains a major problem after solid organ transplantation (SOT), especially in children. Piperacillin-tazobactam (Pip-Tazo) is a beta-lactam-antibiotic combination with a broad spectrum of activity including gram-positive cocci as well as gram-negative rods, non-fermentative and anaerobic bacteria. The aim of this retrospective study was to critically review our experience with Pip-Tazo as perioperative prophylactic agent in pediatric non-renal SOT. Between 1993 and 2003 Pip-Tazo was used as initial perioperative prophylaxis in 45 pediatric patients who underwent a total of 49 transplants (36 liver-, seven cardiac-, two lung-, and four small bowel-) at our department. Median age of the children was 7.9 (range 0.5-18.1) years. A total of 34 rejection episodes following 27 transplants were diagnosed. During first hospitalization 44 infectious episodes were observed. Bacteria were responsible for 22 episodes including sepsis (n = 10), pneumonia (n = 5), wound infection (n = 4), urinary tract infection (n = 1), and clostridial colitis (n = 2). The isolated organisms were gram-positive cocci (n = 12), gram-negative rods (n = 3), non-fermentative bacilli (n = 4), and anaerobes (n = 3). Ten episodes were caused by Pip-Tazo resistant bacteria. Twenty-one of these infections were observed following antirejection therapy with pulse steroids. At later time points nine infectious episodes were successfully treated with a second course of Pip-Tazo. During follow up, eight patients died. Six deceased perioperatively: five from infection including aspergillosis (n = 4) and Pneumocystis jiroveci pneumonia (n = 1) and cerebrovascular bleeding (n = 1) and two children later on. At present 37 children (82%) are alive with well functioning graft after a median follow up of 39.2 (range 0.6-123.5) months. No severe side effects caused by Pip-Tazo were observed in any of the children. Pip-Tazo may be a suitable single agent for perioperative prophylaxis in pediatric non-renal solid organs recipients, however, a prospective comparative study is needed to make final conclusions.

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Piperacillin/Tazobactam: A New Beta-Lactam/Beta-Lactamase Inhibitor Combination

Cited by 45 publications

References 26 publications

Incidence of Neutropenia during Treatment of Bone-Related Infections with Piperacillin-Tazobactam

Incidence of Neutropenia during Treatment of Bone-Related Infections with Piperacillin-Tazobactam

Piperacillin/Tazobactam (ZOSYN)

Experience with the use of piperacillin–tazobactam in pediatric non‐renal solid organ transplantation

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