Piperacillin-Tazobactam
Empiric broad-spectrum coverage, Sepsis, Intra-abdominal infections, Hospital-acquired pneumonia
Indications
- Empiric broad-spectrum coverage
- Sepsis
- Intra-abdominal infections
- Hospital-acquired pneumonia
Adult dosing
- standard: dose: 3.375; unit: g; route: IV; interval: q6h; fixed: true; extended infusion: dose: 4.5; unit: g; route: IV over 4h; interval: q8h; fixed: true
Pediatric dosing
- standard: dose: 100; unit: mg/kg; maxDose: 4500; maxDoseAbsolute: true; route: IV; interval: q8h (piperacillin component); weightBased: true
Contraindications
- Penicillin allergy (true anaphylaxis)
Clinical pearls
- Extended infusion (4.5g over 4 hours q8h) improves outcomes in critically ill — better time above MIC
- Covers gram-positives (not MRSA), gram-negatives, and anaerobes
- Pair with vancomycin for empiric MRSA + broad gram-negative coverage in sepsis
- Does NOT cover atypicals — add azithromycin for CAP
Source and review
- Surviving Sepsis Campaign Guidelines 2021, Sanford Guide. Last reviewed: 2024-09-15