ピペラシリンナトリウム・タゾバクタムナトリウム

使用用途

• Single-agent therapy of intra-abdominal sepsis
• Susceptible infections
• Severe polymicrobic bacteremia
• Preoperative orthopedic or coelomic surgery
• Single-agent therapy of intra-abdominal sepsis
• Bacterial sepsis
• Life-threatening infections (e.g., Pseudomonas)
• Life-threatening infections

投与方法

考えられる副作用

• Hypersensitivity reactions
• Local effects (thrombophlebitis) associated with IV injection
• Antibiotic-associated diarrhea (alterations in gut flora)
• Coagulation abnormalities (rare, particularly in renal failure)
• Neurotoxicity/seizures (at very high doses, especially with diminished renal function)
• Clostridium difficile superinfections (rare)
• Nausea
• Diarrhoea
• Skin rashes
• Pain on intramuscular injection
• Sodium overload (in susceptible patients)

注意事項と禁忌

• Patients with documented hypersensitive reactions to a beta-lactam or beta-lactamase inhibitor
• Known hypersensitivity to penicillins or cephalosporins
• > **High Sodium Content:** High dosages may adversely affect patients with cardiac failure or hypernatremic conditions. * **Renal Impairment:** Dosage adjustment may be required in patients with significantly decreased renal function (CrCl <40 mL/min). * **Laboratory Interference:** May cause false-positive results for urine glucose (cupric sulfate methods like Clinitest), direct antiglobulin (Coombs') tests, and urine protein (sulfosalicylic acid, boiling, nitric acid, or acetic acid tests). May also falsely decrease aminoglycoside serum quantitative analysis if samples are stored prior to analysis.

薬物相互作用

• Aminoglycosides (amikacin, gentamicin, tobramycin): Synergistic or additive activity against certain bacteria. However, penicillins can inactivate aminoglycosides in vitro and in vivo in patients in renal failure or at massive dosages. Amikacin is the most resistant to this inactivation.
• Anticoagulants (heparin, warfarin): Piperacillin may rarely affect platelets; increased monitoring of coagulation parameters is suggested.
• Methotrexate: Piperacillin may increase MTX serum levels.
• Probenecid: Can reduce the renal tubular secretion of both piperacillin and tazobactam, maintaining higher systemic levels for a longer period.
• Vecuronium: Piperacillin may prolong neuromuscular blockade.
• Non-depolarizing muscle relaxants: Piperacillin enhances the effects of non-depolarizing muscle relaxants.
• Gentamicin: Inactivates piperacillin if mixed in the same syringe.
• Aminoglycosides: Synergistic bactericidal effect against pseudomonal septicaemias when administered systemically (not mixed in vitro).

よくある質問