The usual total daily dose of Zosyn for adults is 3. Available for Android and iOS devices. Bacteroides fragilis group B. Diet , food , health , injury , liver , meals , nutrition , organs , Supplements. In patients younger than 2 months of age, clearance of piperacillin is slower compared to older children; however, it is not adequately characterized for dosing recommendations. Mental health is the condition of a person based on the welfare of their state both mentally and emotionally.
Zosyn Dosage and Administration
No information is available on the effects of piperacillin and tazobactam on the breast-fed child or on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for Zosyn and any potential adverse effects on the breastfed child from Zosyn or from the underlying maternal condition.
Safety and efficacy in pediatric patients less than 2 months of age have not been established [ see Clinical Pharmacology 12 and Dosage and Administration 2 ]. Patients over 65 years are not at an increased risk of developing adverse effects solely because of age.
However, dosage should be adjusted in the presence of renal impairment [ see Dosage and Administration 2 ]. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Zosyn contains 65 mg 2. The geriatric population may respond with a blunted natriuresis to salt loading. This may be clinically important with regard to such diseases as congestive heart failure.
This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. Dosage adjustment of Zosyn is not warranted in patients with hepatic cirrhosis [see Clinical Pharmacology As with other semisynthetic penicillins, piperacillin therapy has been associated with an increased incidence of fever and rash in cystic fibrosis patients.
The majority of those events experienced, including nausea, vomiting, and diarrhea, have also been reported with the usual recommended dosages. Patients may experience neuromuscular excitability or convulsions if higher than recommended doses are given intravenously particularly in the presence of renal failure [ see Warnings and Precautions 5.
Treatment should be supportive and symptomatic according the patient's clinical presentation. Excessive serum concentrations of either piperacillin or tazobactam may be reduced by hemodialysis. Following a single 3. The chemical name of piperacillin sodium is sodium 2 S ,5 R ,6 R [ R 4-ethyl-2,3-dioxopiperazine-carboxamido phenylacetamido]-3,3-dimethyloxothiaazabicyclo[3.
The chemical structure of piperacillin sodium is:. Tazobactam sodium, a derivative of the penicillin nucleus, is a penicillanic acid sulfone. Its chemical name is sodium 2 S, 3 S, 5 R methyloxo 1 H -1,2,3-triazolylmethyl thiaazabicyclo[3. The chemical structure of tazobactam sodium is:.
Zosyn piperacillin and tazobactam for Injection, is a white to off-white sterile, cryodesiccated powder consisting of piperacillin and tazobactam as their sodium salts packaged in glass vials. The formulation also contains edetate disodium dihydrate EDTA and sodium citrate.
The product also contains 0. The product also contains 1 mg of EDTA per vial. Zosyn is an antibacterial drug [ see Microbiology Peak plasma concentrations of piperacillin and tazobactam are attained immediately after completion of an intravenous infusion of Zosyn.
Piperacillin plasma concentrations, following a minute infusion of Zosyn, were similar to those attained when equivalent doses of piperacillin were administered alone. Steady-state plasma concentrations of piperacillin and tazobactam were similar to those attained after the first dose due to the short half-lives of piperacillin and tazobactam.
The protein binding of either piperacillin or tazobactam is unaffected by the presence of the other compound. Protein binding of the tazobactam metabolite is negligible. Piperacillin and tazobactam are widely distributed into tissues and body fluids including intestinal mucosa, gallbladder, lung, female reproductive tissues uterus, ovary, and fallopian tube , interstitial fluid, and bile.
Distribution of piperacillin and tazobactam into cerebrospinal fluid is low in subjects with non-inflamed meninges, as with other penicillins see Table 6. Piperacillin is metabolized to a minor microbiologically active desethyl metabolite. Tazobactam is metabolized to a single metabolite that lacks pharmacological and antibacterial activities. Following single or multiple Zosyn doses to healthy subjects, the plasma half-life of piperacillin and of tazobactam ranged from 0.
Both piperacillin and tazobactam are eliminated via the kidney by glomerular filtration and tubular secretion. Piperacillin, tazobactam and desethyl piperacillin are also secreted into the bile. See Dosage and Administration 2 for specific recommendations for the treatment of patients with renal -impairment. For dosage recommendations for patients undergoing hemodialysis [ see Dosage and Administration 2 ]. However, this difference does not warrant dosage adjustment of Zosyn due to hepatic cirrhosis.
Piperacillin and tazobactam pharmacokinetics were studied in pediatric patients 2 months of age and older. The clearance of both compounds is slower in the younger patients compared to older children and adults. In a population PK analysis, estimated clearance for 9 month-old to 12 year-old patients was comparable to adults, with a population mean SE value of 5. In patients younger than 2 months of age, clearance of piperacillin is slower compared to older children; however, it is not adequately characterized for dosing recommendations.
The population mean SE for piperacillin distribution volume is 0. This difference may be due to age-related changes in creatinine clearance.
The effect of race on piperacillin and tazobactam was evaluated in healthy male volunteers. The potential for pharmacokinetic drug interactions between Zosyn and aminoglycosides, probenecid, vancomycin, heparin, vecuronium, and methotrexate has been evaluated [ see Drug Interactions 7 ]. Piperacillin sodium exerts bactericidal activity by inhibiting septum formation and cell wall synthesis of susceptible bacteria. In vitro , piperacillin is active against a variety of Gram-positive and Gram-negative aerobic and anaerobic bacteria.
Tazobactam sodium has little clinically relevant in vitro activity against bacteria due to its reduced affinity to penicillin-binding proteins. Bacteroides fragilis group B. The following in vitro data are available, but their clinical significance is unknown. Enterococcus faecalis ampicillin or penicillin-susceptible isolates only Staphylococcus epidermidis methicillin susceptible isolates only. Streptococcus agalactiae 2 Streptococcus pneumoniae 2 penicillin-susceptible isolates only Streptococcus pyogenes 2 Viridans group streptococci 2.
Citrobacter koseri Moraxella catarrhalis Morganella morganii Neisseria gonorrhoeae Proteus mirabilis Proteus vulgaris Serratia marcescens Providencia stuartii Providencia rettgeri Salmonella enterica.
Clostridium perfringens Bacteroides distasonis Prevotella melaninogenica. As is recommended with all antimicrobials, the results of in vitro susceptibility tests, when available, should be provided to the physician as periodic reports, which describe the susceptibility profile of nosocomial and community-acquired pathogens. These reports should aid the physician in selecting the most effective antimicrobial. Quantitative methods are used to determine antimicrobial minimum inhibitory concentrations MICs.
These MICs provide estimates of the susceptibility of bacteria to antimicrobial compounds. The MICs should be determined using a standardized procedure. Standardized procedures are based on a dilution method broth or agar or equivalent with standardized inoculum concentrations and standardized concentrations of piperacillin and tazobactam powders. The MIC values obtained should be interpreted according to criteria provided in Table 7.
Quantitative methods that require measurement of zone diameters also provide reproducible estimates of the susceptibility of bacteria to antimicrobial compounds.
The zone size provides an estimate of the susceptibility of bacteria to antimicrobial compounds. The zone size should be determined using a standardized test method 2,4 and requires the use of standardized inoculum concentrations.
The disk diffusion interpreted criteria are provided in Table 7. A report of S "Susceptible" indicates that the pathogen is likely to be inhibited if the antimicrobial compound in the blood reaches the concentration at the infection site necessary to inhibit growth of the pathogen.
A report of I "Intermediate" indicates that the results should be considered equivocal, and if the microorganism is not fully susceptible to alternative, clinically feasible drugs, the test should be repeated. This category implies possible clinical applicability in body sites where the drug is physiologically concentrated or in situations where high dosage of drug can be used. This category also provides a buffer zone, which prevents small, uncontrolled technical factors from causing major discrepancies in interpretation.
A report of R "Resistant" indicates that the pathogen is not likely to be inhibited even if the antimicrobial compound in the blood reaches the concentration usually achievable at the infection site; other therapy should be considered.
Standardized susceptibility test procedures require the use of quality controls to monitor and ensure the accuracy and precision of supplies and reagents used in the assay, and the techniques of the individuals performing the test procedures.
Quality control bacteria are specific strains of bacteria with intrinsic biological properties relating to resistance mechanisms and their genetic expression within the microorganism; the specific strains used for microbiological quality control are not clinically significant.
Zosyn piperacillin and tazobactam for Injection are supplied as single-dose vials and pharmacy bulk vials in the following sizes:. Advise patients, their families, or caregivers that serious hypersensitivity reactions, including serious allergic cutaneous reactions, could occur that require immediate treatment.
Ask them about any previous hypersensitivity reactions to Zosyn, other beta-lactams including cephalosporins , or other allergens [ see Warnings and Precautions 5. Advise patients, their families, or caregivers that diarrhea is a common problem caused by antibacterial drugs which usually ends when the drug is discontinued. Sometimes after starting treatment with antibacterial drugs, patients can develop watery and bloody stools with or without stomach cramps and fever even as late as two or more months after having taken the last dose of the drug.
If this occurs, patients should contact their physician as soon as possible. Counsel patients that antibacterial drugs including Zosyn should only be used to treat bacterial infections. They do not treat viral infections e. When Zosyn is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed.
Skipping doses or not completing the full course of therapy may 1 decrease the effectiveness of the immediate treatment and 2 increase the likelihood that bacteria will develop resistance and will not be treatable by Zosyn or other antibacterial drugs in the future. Bacteremia ciprofloxacin , metronidazole , clindamycin , vancomycin , Flagyl , More By clicking Subscribe, I agree to the Drugs. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records.
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We comply with the HONcode standard for trustworthy health information - verify here. Administration of amikacin or gentamicin in a single daily dose or in doses exceeding those stated above via Y-site with Zosyn containing EDTA has not been evaluated. See package insert for each aminoglycoside for complete Dosage and Administration instructions.
This product's label may have been updated. For current package insert and further product information, please visit http: Print this page Add to My Med List.
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