Vol. 23 No. 1 (2024)
Literature Review

Piperacillin-Tazobactam: update for clinical use

Rodrigo Siqueira-Batista
Universidade Federal de Viçosa

Published 2024-08-21

Keywords

  • Anti-Bacterial Agents; Piperacillin, Tazobactam Drug Combination; beta-Lactams

How to Cite

1.
Rezende Correa e Castro Costa A, Gomes AP, Vieira Varejão EV, Will RB, Tavares W, Santana LA, Siqueira-Batista R. Piperacillin-Tazobactam: update for clinical use. BJHBS [Internet]. 2024 Aug. 21 [cited 2024 Sep. 16];23(1). Available from: https://bjhbs.hupe.uerj.br/bjhbs/article/view/165

Abstract

Introduction: Piperacillin-tazobactam, a broad-spectrum penicillin, represents a crucial option in the treatment of infections, especially in critically ill patients who exhibit high rates of resistance to various antimicrobial agents. It is of paramount importance to understand this medication and its updates regarding its clinical use to inform precise therapeutic choices aimed at optimizing patient care. Objective: To describe the main pharmacological and therapeutic aspects of piperacillin-tazobactam, highlighting its clinical application and updates related to its use. Methods: A narrative review of the literature was conducted to provide an update on the most relevant aspects related to piperacillin-tazobactam, including (1) a brief history; (2) chemical structure; (3) mechanism of action; (4) resistance mechanisms; (5) spectrum; (6) major clinical uses; and (7) adverse effects. Results: The safe use of piperacillin-tazobactam necessitates rapid testing for antimicrobial resistance patterns, discouraging its empirical use in cases of ESBL-producing microorganisms. In patients undergoing renal replacement therapy, it is crucial to establish antibiotic goals promptly. For critically ill patients, monitoring pharmacodynamic and pharmacokinetic variability is essential. Conclusion: Piperacillin-tazobactam remains a vital drug in the management of critically ill patients, requiring constant updates. Furthermore, there is a need for further studies, especially concerning its continuous use and the selection of alternatives to carbapenem-resistant medications.

Metrics

Metrics Loading ...

References

  1. Bennet JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennet’s Principles and Practice of Infectious Diseases . 9th ed. Philadelphia: Elsevier; 2020
  2. Tavares W. Antibióticos e Quimioterápicos para o clínico. 4. ed. São Paulo: Atheneu; 2020.
  3. Pilmis B, Jullien V, Tabah A, et al. Piperacillin–tazobactam as alternative to carbapenems for ICU patients. Annals of Intensive Care [Internet]. 2017 Nov 10;7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5681454/
  4. Gin A, Dilay L, Karlowsky JA, Walkty A, Rubinstein E, Zhanel GG. Piperacillin–tazobactam: a β-lactam/β-lactamase inhibitor combination. Expert Review of Anti-infective Therapy. 2007 Jun;5(3):365–83.
  5. Goodman LS, Gilman AG, Brunton LL, et al. As Bases Farmacológicas da Terapêutica de Goodman & Gilman. Porto Alegre (Rs): AMGH; 2012.
  6. Selig DJ, DeLuca JP, Chung KK, et al. Pharmacokinetics of piperacillin and tazobactam in critically Ill patients treated with continuous kidney replacement therapy: A mini‐review and population pharmacokinetic analysis. Journal of Clinical Pharmacy and Therapeutics. 2022 Mar 29;47(8):1091–102.
  7. Kornmehl H, Gorouhi F, Konia T, et al. Generalized fixed drug eruption to piperacillin/tazobactam and review of literature. Dermatology Online Journal [Internet]. 2018 Apr 15 [cited 2023 Nov 3];24(4):13030/qt8cr714g5. Available from: https://pubmed.ncbi.nlm.nih.gov/29906010/
  8. Tipos de Revisão de Literatura [Internet]. 2015 [cited 2023 Nov 3]. Available from: https://www.fca.unesp.br/Home/Biblioteca/tipos-de-evisao-de-literatura.pdf
  9. Elias C de SR, Silva LA da, Martins MT de SL, Ramos NAP, Souza M das GG de, Hipólito RL. Quando chega o fim?: uma revisão narrativa sobre terminalidade do período escolar para alunos deficientes mentais. SMAD Revista eletrônica saúde mental álcool e drogas [Internet]. 2012 Apr 1[cited 2023 Nov 3];8(1):48–53. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1806-69762012000100008
  10. Rother ET. Systematic literature review X narrative review. Acta Paulista de Enfermagem [Internet]. 2007 Jun;20(2):v–vi. Available from: http://www.scielo.br/scielo.php?pid=S0103-21002007000200001&script=sci_arttext&tlng=en
  11. Vardanyan RS, Hruby VJ. Synthesis of essential drugs. Amsterdam: Elsevier Science; 2006.
  12. Neu HC. β-Lactam Antibiotics: Structural Relationships Affecting in Vitro Activity and Pharmacologic Properties. Clinical Infectious Diseases. 1986 Jul 1;8(Supplement_3):S237–59.
  13. Fernandes R, Amador P, Prudêncio C. β-Lactams: chemical structure mode of action and mechanisms of resistence. Reviews in Medical Microbiology. 2013 Jan;24(1):7–17.
  14. Solomons TWWG, Fryhle CB. Química Orgânica. 10th ed. LTC; 2013.
  15. De Rosa M, Verdino A, Soriente A, Marabotti A. The Odd Couple(s): An Overview of Beta-Lactam Antibiotics Bearing More Than One Pharmacophoric Group. International Journal of Molecular Sciences. 2021 Jan 9;22(2):617.
  16. Siqueira-Batista R, Alves MMR, Lara MAG, et al. Penicilinas: atualização para a prática clínica. Revista Médica de Minas Gerais [Internet]. 2023 Aug 31;33. Available from: https://rmmg.org/artigo/detalhes/4016
  17. Gage-Brown A, George C, Maleki J, et al. Is Piperacillin-Tazobactam an Appropriate Empirical Agent for Hospital-Acquired Sepsis and Community-Acquired Septic Shock of Unknown Origin in Australia? Healthcare. 2022 May 5;10(5):851.
  18. Schuetz AN, Reyes S, Tamma PD. Point-Counterpoint: Piperacillin-Tazobactam Should Be Used To Treat Infections with Extended-Spectrum-Beta-Lactamase-Positive Organisms. Caliendo AM, editor. Journal of Clinical Microbiology. 2018 Mar;56(3).
  19. Jorge PRF, Pimenta JP, Brito CS de, et al. Pseudomonas aeruginosa resistente aos carbapenêmicos produtor de NDM-1. Revista Médica de Minas Gerais [Internet]. 2023 Aug 31;33(1). Available from: https://rmmg.org/artigo/detalhes/4014
  20. Rabiei MM, Asadi K, Shokouhi S, et al. Antipseudomonal β-Lactams Resistance in Iran. International Journal of Microbiology [Internet]. 2020 Dec 16;2020:e8818315. Available from: https://www.hindawi.com/journals/ijmicro/2020/8818315/
  21. El-Haffaf I, Caissy JA, Marsot A. Piperacillin-Tazobactam in Intensive Care Units: A Review of Population Pharmacokinetic Analyses. Clinical Pharmacokinetics. 2021 Apr 20;60(7):855–75.