Piperacillin with tazobactam

How it works

Piperacillin inhibits bacterial cell-wall synthesis by binding penicillin-binding proteins, while tazobactam irreversibly inhibits many bacterial beta-lactamases, restoring and extending activity against otherwise resistant Gram-negative and anaerobic organisms.

Prescribing in practice

• It contains a penicillin and is contraindicated in patients with a history of severe hypersensitivity to penicillins or other beta-lactams — check allergy status before administration.
• The dose must be reduced in renal impairment, and the significant sodium content should be considered in patients with cardiac failure or sodium restriction.
• Reduced efficacy of combined hormonal contraception is a recognised antibiotic caution, and concurrent use with certain anticoagulants warrants closer monitoring.

Monitoring

Monitor renal function, electrolytes and full blood count during prolonged therapy, as neutropenia and electrolyte disturbance can occur.

Counselling the patient

• This antibiotic is given by drip into a vein in hospital for serious infection.
• Tell the team immediately about any allergy to penicillin or other antibiotics.
• Report any rash, breathing difficulty, or severe or persistent diarrhoea during or after treatment.

Evidence & guidelines

Piperacillin with tazobactam is a widely used empirical agent in UK hospital sepsis and antimicrobial protocols for serious infection.