Piperacillin-Tazobactam (Piperacillin + Tazobactam)
Also sold as: Zosyn, Pip-Tazo, Tazocin
Pregnancy
Cat B
Lactation
Safe
Schedule
H
Forms
IV/IM injection (2.25g, 4.5g) +1
Indications
- Hospital-acquired / nosocomial pneumonia
- Complicated intra-abdominal infections
- Complicated UTI with sepsis
- Polymicrobial infections
- Febrile neutropenia (empiric)
- Severe infections in ICU
Adult Dosing
Severe infection/sepsis
4.5 g IV Q6-8H (piperacillin component)
7-14 days
Intra-abdominal
4.5 g IV Q6-8H
5-14 days
Febrile neutropenia
4.5 g IV Q4-6H
7-10 days
Pediatric Dosing
Dosing based on weight; adjust for renal function
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 40 mL/min | No adjustment |
| CrCl 20-40 mL/min | 2.25 g IV Q6H |
| CrCl < 20 mL/min | 2.25 g IV Q8H |
| Hemodialysis | 2.25 g IV Q8H; supplemental dose during/after dialysis |
Hepatic Adjustment
No adjustment required
Pregnancy & Lactation
Pregnancy: Category B
Generally safe in pregnancy; used for serious infections in pregnant patients.
Lactation: Safe
Likely compatible; small amounts in breast milk.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Metronidazole | Synergistic anaerobic coverage (no dose adjustment) | Minor |
| Aminoglycosides | Synergistic activity; inactivation if mixed in same IV bag (give separately) | Major |
| Probenecid | Increases piperacillin levels | Moderate |
| Warfarin | Enhanced anticoagulant effect; monitor INR | Moderate |
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Side Effects
Common
- Phlebitis at infusion site
- Diarrhea
- Nausea
- Headache
- Fever
Serious / Discontinue If
- Anaphylaxis (beta-lactam allergy)
- C. difficile colitis
- Seizures (especially in renal impairment)
- Interstitial nephritis
Contraindications
- Beta-lactam hypersensitivity
- Severe penicillin allergy (IgE-mediated)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Zosyn 2.25g IV | Pfizer | 1 vial ₹350 |
| Pip-Tazo 4.5g IV | Cipla | 1 vial ₹280 |
| Tazocin 2.25g | GSK | 1 vial ₹320 |
Monitoring Required
- Renal function daily
- LFT in prolonged use (>2 weeks)
- CBC for signs of bone marrow effects
- Prothrombin time if on warfarin
- Signs of C. difficile
Patient Counseling Points
- IV use only; hospital/clinic administration
- Report fever, rash, or signs of phlebitis
- Inform doctor of penicillin allergy history
- Used for serious infections; compliance essential
Stop Googling drug references mid-consultation
EasyClinic auto-flags Piperacillin-Tazobactam interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Vikram Singh, MD (Critical Care), ICU Specialist
Last reviewed: 2026-04-11
References
- BNF — Piperacillin-Tazobactam
- Surviving Sepsis Campaign 2023
- IDSA Neutropenia Guidelines