Tazobac 2.25 IV Infusion

✔️ Side Effects

Skin: Rash, pruritus, purpura

GI system: Diarrhea, nausea, vomiting, abdominal pain, dyspepsia, constipation

General/systemic: Fever, chills, injection-site reactions

Immune: Hypersensitivity, anaphylaxis (rare but serious)

Other reported: candidiasis, pseudomembranous colitis, hypoglycemia, myalgia, arthralgia, insomnia, phlebitis, hypotension, flushing, epistaxis

✔️ Dosage & Administration

is Route: Intravenous infusion over 30 minutes.

Adults

Standard dose: 3.375 g every 6 hours (total 13.5 g/day: 12 g piperacillin + 1.5 g tazobactam).

Duration: Typically 7–10 days.

Nosocomial pneumonia: 4.5 g every 6 hours plus an aminoglycoside (total 18 g/day). Duration 7–14 days. Continue aminoglycoside if P. aeruginosa is isolated.

Pediatrics

≥9 months, ≤40 kg: 100 mg piperacillin + 12.5 mg tazobactam/kg every 8 hrs.

2–9 months: 80 mg piperacillin + 10 mg tazobactam/kg every 8 hrs.

40 kg: Use adult dosing.

Dosing for children with renal impairment has not been established.

1. Pediatrics: Safe in ≥2 months with appendicitis/peritonitis; renal dosing not defined.
2. Geriatrics: No age-specific risk, but dose adjustment required in renal impairment.
3. Renal impairment: Reduce dose if creatinine clearance ≤40 mL/min; adjust for hemodialysis/CAPD.
4. Hepatic impairment: No dose adjustment needed.
5. Cystic fibrosis: Higher risk of rash and fever.

✔️ Reconstitution & Administration

• Reconstitute vial with 20 mL 0.9% sodium chloride. Mix thoroughly until dissolved.
• Transfer solution to IV bag with 0.9% sodium chloride.
• Infuse over 30 minutes.
• Use immediately after reconstitution.
• Stability: Up to 24 hrs at room temp (20–25°C) or 48 hrs refrigerated (2–8°C).
• Do not freeze after reconstitution.

✔️ Drug Interactions

• Aminoglycosides: May be inactivated by piperacillin; monitor levels in renal impairment.
• Probenecid: Prolongs half-life of both drugs by inhibiting renal secretion—coadministration not recommended unless necessary.
• Anticoagulants: Monitor coagulation parameters when used with heparin, oral anticoagulants, or platelet-affecting drugs.
• Vecuronium & other non-depolarizing muscle relaxants: Risk of prolonged neuromuscular blockade.
• Methotrexate: Reduced clearance possible—monitor methotrexate levels and toxicity signs.

✔️ Contraindications

Known hypersensitivity to penicillins, cephalosporins, or β-lactamase inhibitors.

✔️ Pregnancy & Lactation

Crosses the placenta. Insufficient human data to confirm risks of birth defects/miscarriage.

Piperacillin is excreted in breast milk; tazobactam excretion has not been studied. Effects on nursing infants and milk production are unknown.

✔️ Precautions & Warnings

Risk of serious hypersensitivity reactions (anaphylaxis, anaphylactoid).

Severe cutaneous adverse reactions possible (e.g., Stevens-Johnson syndrome, TEN, DRESS, AGEP).

Hematologic effects (bleeding, leukopenia, neutropenia) – monitor blood counts in prolonged use.

May increase nephrotoxicity risk in critically ill patients. Monitor renal function.

Risk of Clostridium difficile–associated diarrhea.

Use caution in patients with renal impairment, cystic fibrosis, or prolonged therapy.

✔️ Storage Conditions

Store powder at below 30°C, protected from light and moisture.

Keep out of reach of children.