💊 Piperacillin–Tazobactam (Tazocin, US: Zosyn) – combination of piperacillin 4 g and tazobactam 0.5 g per vial.
👩‍⚕️ Broad-spectrum coverage – particularly useful in Pseudomonas and severe hospital-acquired infections.
Often used in neutropenic sepsis and ICU patients with severe sepsis.
May be combined with gentamicin for synergy in critically ill patients.

⚡ Mechanism of Action

🔪 Piperacillin: bactericidal, inhibits bacterial cell wall synthesis.
🛡️ Tazobactam: beta-lactamase inhibitor, protecting piperacillin from enzymatic destruction.
🤝 Synergistic when combined with aminoglycosides (e.g. gentamicin).

🧬 Antimicrobial Spectrum

✅ Gram-positive aerobes: Streptococci, Staphylococcus aureus (not MRSA).
✅ Gram-negative aerobes: E. coli, Klebsiella, Haemophilus influenzae, Acinetobacter, Pseudomonas aeruginosa.
✅ Anaerobes: including Bacteroides fragilis group.
❌ Not effective against MRSA, VRE, or atypical organisms (e.g. Mycoplasma, Chlamydia).

🩺 Indications

Severe pneumonia (including hospital- and ventilator-associated).
Complicated intra-abdominal infections.
Complicated UTIs and pyelonephritis.
Skin and soft tissue infections (e.g. diabetic foot, necrotising fasciitis as part of combination therapy).
Neutropenic sepsis (often with gentamicin).
Bone marrow transplant or immunocompromised patients with resistant coliform infections.

💊 Dosing – Piperacillin–Tazobactam (verify with BNF/datasheet)

Indication	Details
🦠 Severe Infections	Piperacillin–Tazobactam • 2.25 – 4.5 g IV infusion over 30 min • Every 6–8 hours
🧬 Neutropenic Sepsis (with Gentamicin)	Piperacillin–Tazobactam • 4.5 g IV infusion over 30 min • Every 6 hours

📉 Dose reduction required in renal impairment (see BNF/local policy).

🔄 Interactions

⬆️ Nephrotoxicity risk when combined with aminoglycosides – monitor renal function closely.
⬆️ Increased risk of bleeding with anticoagulants (affects platelet aggregation).
⬆️ May raise methotrexate levels (reduced clearance).
Possible reduced efficacy of oral contraceptives (advise precautions).

⚠️ Cautions

Renal impairment → adjust dosing to avoid accumulation.
Liver impairment → monitor LFTs if prolonged therapy.
Prolonged use can predispose to C. difficile colitis and resistant organisms.

🚫 Contraindications

Known penicillin allergy (consider alternatives e.g. meropenem if safe).

💥 Side Effects

🤢 GI: nausea, vomiting, diarrhoea, antibiotic-associated colitis.
🫁 Allergy: rash, urticaria, angioedema, anaphylaxis.
🩸 Haematological: haemolytic anaemia, leucopenia, thrombocytopenia.
🩺 Renal: interstitial nephritis.
🧪 Hepatic: jaundice, hepatitis, abnormal LFTs.
⚠️ Severe skin reactions: Stevens–Johnson syndrome, TEN (rare).
💉 Hypoglycaemia reported with high-dose/prolonged use.

📑 References

BNF: Piperacillin–Tazobactam
NICE Antimicrobial Guidance

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Tazocin (Tazobactam - Piperacillin)

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