see also:

• antibiotics

• broad spectrum parenteral antibiotic + beta-lactamase inhibitor reserved for defined uses for serious sepsis such as:
  • ascending cholangitis and other intra-abdominal sepsis
  • urosepsis resistant to other antibiotics

• HS to penicillins, cephalosporins or beta-lactamase inhibitors

• prolonged use >= 21 days
• monitor FBE, LFT's and U&Es
• renal or hepatic impairment
• contains high Na content of 64mg/g of piperacillin
• cystic fibrosis
• not advised for Rx of brain abscesses or meningitis
• pregnancy
• lactation
• children < 2yrs
• may mask syphilis infections

• Admin by IV infusion over 20-30 min
• Rx for 5-14 days (48 hrs beyond clinical symptom, fever resolution)
• see product information

• usual dose: 4 g/0.5 g every 8 hrs
• renal impairment:
  • ClCr 20-40 mL/min: 4 g/0.5 g every 8 hrs (equiv. 12 g/1.5 g/day);
  • ClCr < 20 mL/min: 4 g/0.5 g every 12 hrs (equiv. 8 g/1 g/day).
  • Haemodialysis:
    • admin additional 2 g/0.25 g dose postdialysis; max 8 g/1 g/day.
  • coadmin with aminoglycoside antibiotics (amikacin, gentamicin): see full PI

• usual dose:
  • up to 40 kg: 100 mg/12.5 mg/kg every 8 hrs;
  • > 40 kg: 4 g/0.5 g every 8 hrs

• GI upset;
• rash, erythema, pruritus, urticaria, allergic reaction;
• superinfection;
• phlebitis, thrombophlebitis;
• insomnia; headache;
• blood dyscrasia; incr AST, ALT, creatinine;
• fever; inj site reaction;
• candidiasis;
• rare: interstitial nephritis, renal failure, hepatitis, arthralgia, flushing, pseudomembranous colitis; severe skin reaction (very rare);

• heparin, oral anticoagulants
• aminoglycoside antibiotics
• nondepolarising muscle relaxants eg vecuronium;
• methotrexate; cytotoxic agents;
• diuretics; probenecid;
• lab tests: urine glucose (Cu reduction method), Platelia Aspergillus EIA (Bio-Rad Laboratories) (see full PI);
• do not admix;
  • should not be added to NaHCO3, basic solns, blood products, albumin hydrolysates