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Piperacillin

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Piperacillin
Systematic (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
Identifiers
CAS number 66258-76-2
ATC code J01CA12
PubChem 43672
DrugBank APRD00325
Chemical data
Formula C23H26N5O7S 
Mol. weight 516.548 g/mol
Pharmacokinetic data
Bioavailability not absorbed orally
Metabolism largely not metabolised
Half life 36–72 minutes
Excretion 20% in bile, 80% unchanged in urine
Therapeutic considerations
Pregnancy cat.

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Legal status

POM(UK)

Routes IV, IM

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).

Contents

[edit] 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 3.375–4.5g every 6 hours. In the UK, the usual dose is 4.5g ever 8 hours; but is licensed to be given as 2.25–4.5g every 6–8 hours. The drug may also be given by continuous infusion, but this has not been shown to be superior.<ref>Lau W, Mercer D, Itani K, et al. (2006). "Randomized, open-label, comparative study of piperacillin-tazobactam administered by continuous infusion versus intermittent infusion for treatment of hospitalized patients with complicated intra-abdominal infection". Antimicrob Agents Chemother 50 (11): 3556–61. PMID 16940077.</ref>

[edit] 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)

[edit] References

<references/>

[edit] External links


Penicillins (J01C) edit

Amoxicillin, Ampicillin, Azlocillin, Carbenicillin, Cloxacillin, Dicloxacillin, Flucloxacillin, Mezlocillin, Nafcillin, Piperacillin, Ticarcillin

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