Who can administer
  
                  May be administered by registered competent doctor or nurse/midwife
      
  
        Important information
  
                  
- Piperacillin/Tazobactam is a Penicillin antibiotic. Enquire and clearly document the patient's allergy status prior to giving or prescribing this medicine
 
- Flush the line before and after giving Piperacillin/Tazobactam, particularly where gentamicin or other aminoglycosides are concerned (in order to avoid inactivation of the aminoglycosides)
 
- All brands contain Sodium (approx 10mmol per 4.5g vial)- if sodium load is important (ref 1)
 
- See under 'Dose' for adjustments required in renal impairment
 
      
  
        Available preparations
  
                  Piperacillin/Tazobactam (4g/0.5g)
Piperacillin/Tazobactam (2g/0.25g)
(Tazocin- search synonym)
      
  
        Reconstitution
  
                  Sodium chloride 0.9% or Water for injection 
Add 10ml to each 2.25g
Add 20ml to each 4.5g
- Shake the vial vigorously for one to two minutes
 
- The displacement value is significant - withdraw the whole volume in the vial after reconstitution for administration of the whole dose (ref 1)
 
      
  
        Infusion fluids
  
                  Sodium chloride 0.9% or Glucose 5%
Glucose 5% may be preferred for high doses (to avoid Sodium load)
      
  
        Methods of intravenous administration
  
                  Intermittent intravenous infusion
- Add required dose to 100ml infusion fluid and administer over 30 minutes
 
- To prepare infusion, attach a 100ml infusion bag to the vial using the Braun Transofix (ref 4090500) device
 
- See further information re smaller volume infusions if required
 
      
  
        Dose in adults
  
                  Neutropenic sepsis, Sepsis source unclear (ref 2), Hospital Acquired Pneumonia,
- Give 4.5g every six hours
 
Other infections
- Give 4.5g every eight hours
 
| Renal impairment | 
| eGFR (ml per minute/1.73m2) | 
Dose | 
Frequency | 
| 20 to 40 | 
4.5g | 
Every eight hours | 
| less than 20 | 
4.5g | 
Every twelve hours | 
| Renal replacement therapy | 
Consult pharmacy or specialist text | 
Hepatic Impairment: No dose adjustment is necessary
      
  
        Monitoring
  
                  
- Monitor FBC, renal and hepatic function during prolonged treatment
 
      
  
        Further information
  
                  
- While an infusion volume of 50ml or 100ml may be used, a 100ml volume is recommended in order to reduce the amount of drug lost in the 'residual volume' of the administration set (which can be up to 20ml - ie 40% of drug lost). A smaller volume infusion of 50ml may be used, but care must be taken to flush through the drug solution remaining in the line.
 
      
  
        Storage
  
                  
      
  
        References
  
                  Piperacillin/Tazobactam 4g/0.5g Viatris 23/09/2024
1.Medusa- Injectable drugs guide, downloaded 08/01/2025
2: GAPP app- accessed online
      
  
        Therapeutic classification
  
                  Broad-spectrum antipseudomonal penicillin with beta-lacatamase inhibitor