Piperacillin

Piperacillin

Clinical data
Pregnancy category	B
Routes of administration	IV, IM
ATC code	J01CA12 (WHO)
Legal status
Legal status	UK: POM (Prescription only)
Pharmacokinetic data
Bioavailability	not absorbed orally
Metabolism	largely not metabolised
Elimination half-life	36–72 minutes
Excretion	20% in bile, 80% unchanged in urine
Identifiers
IUPAC name (2S,5R,6R)-6-{[(2R)-2-[(4-ethyl-2,3-dioxo-piperazine- 1-carbonyl)amino]-2-phenyl-acetyl]amino}-3,3-dimethyl- 7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid
CAS Number	66258-76-2
PubChem CID	43672
DrugBank	APRD00325
E number	{{#property:P628}}
ECHA InfoCard	{{#property:P2566}}
Chemical and physical data
Formula	C23H26N5O7S
Molar mass	516.548 g/mol

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Overview

Piperacillin is an extended spectrum beta-lactam antibiotic of the ureidopenicillin class. It is normally used together with a beta-lactamase inhibitor such as tazobactam, which is commercially available as Tazocin or Zosyn. The combination has activity against many Gram-positive and Gram-negative pathogens and anaerobes, including Pseudomonas aeruginosa.

Piperacillin/tazobactam is administered intravenously. Its main uses are in intensive care medicine (pneumonia, peritonitis), some diabetes-related foot infections and empirical therapy in febrile neutropenia (e.g. after chemotherapy).

Dosing

Piperacillin is not absorbed orally, and must therefore be given by intravenous or intramuscular injection. The doses available differ slightly from country to country.

The doses listed here are adult doses. In the U.S., the dose is 3.375–4.5 g every 6 hours. In the UK, the usual dose is 4.5 g every 8 hours; but is licensed to be given as 2.25–4.5 g every 6–8 hours. The drug may also be given by continuous infusion, but this has not been shown to be superior.

Trade names and preparations

Piperacillin alone:

• Pipracil (U.S. only)

Piperacillin/tazobactam:

• Tazocin (UK, marketed by Lederle)
• Tazocin (Japan, marketed by Toyama)
• Tazocin (New Zealand, marketed by Wyeth)
• Zosyn (U.S., marketed by Wyeth-Ayerst)

External links

• Zosyn (piperacillin/tazobactam combination) - information for U.S.
• Tazocin data sheet for New Zealand