Tazocin EF Dosage/Direction for Use

Piperacillin/tazobactam must be given by slow intravenous infusion (e.g. over 20-30 minutes) or slow intravenous injection (over at least 3-5 minutes).
Duration of Therapy: The duration of therapy should be guided by the severity of the infection and the patient's clinical and bacteriological progress.
Dosage: Neutropenic patients with signs of infection (e.g. fever) should receive immediate empirical antibiotic therapy before laboratory results are available.
Adults and Children Aged 12 Years and Older: In general, the recommended total daily dosage is 12 g of piperacillin/1.5 g of tazobactam given in divided doses every 8 hours. The total daily dose depends on the severity and localization of the infection and can vary from 2.25 g to 4.5 g piperacillin/tazobactam administered every 6 or 8 hours.
For bacterial infections in neutropenic patients, the recommended dose is 4 g piperacillin/0.5 g tazobactam administered every 6 hours in combination with an aminoglycoside.
Pediatric Neutropenia: <50 kg: For children with normal renal function and weighing less than 50 kg, the dose should be adjusted to 80 mg of piperacillin/10 mg of tazobactam per kilogram of body weight every 6 hours, in combination with the appropriate dose of an aminoglycoside.
>50 kg: For children weighing over 50 kg, follow the adult dosing, in combination with the appropriate dose of an aminoglycoside.
Children under the Age of 12 Years: The following table summarises the treatment frequency and the dose per body weight for children under 12 years of age by indication or condition: (See Table 5.)

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Until further experience is available, piperacillin/tazobactam should not be used in children who do not have neutropenia.
Elderly: No dose adjustment is required for the elderly with normal renal function or creatinine clearance values above 40 mL/min.
Use in Patients with Renal Impairment: The intravenous dose should be adjusted to the degree of actual renal impairment as follows (each patient must be monitored closely for signs of substance toxicity; medicinal product dose and interval should be adjusted accordingly): (See Table 6.)

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For patients on hemodialysis, one additional dose of piperacillin/tazobactam 2 g/0.25 g should be administered following each dialysis period, because haemodialysis removes 30%-50% of piperacillin in 4 hours.
Children under the Age of 12 Years: (See Table 7.)

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For children on haemodialysis, one additional dose of 40 mg piperacillin/5 mg tazobactam/kg should be administered following each dialysis period.
The pharmacokinetics of piperacillin/tazobactam have not been studied in pediatric patients with renal impairment. Each patient must be monitored closely for signs of drug toxicity. Drug dose and interval dose should be adjusted accordingly. In patients with renal insufficiency or hemodialysis patients, intravenous dosages and administration intervals should be adjusted to the degree of renal function impairment.
Use in Children Aged Below 2 Years: The safety and efficacy of piperacillin/tazobactam in children 0-2 years of age has not been established.
No data from controlled clinical studies are available.
Use in Patients with Hepatic Impairment: No dosage adjustment is necessary in patients with hepatic impairment.
Co-administration of Piperacillin/Tazobactam with Aminoglycosides: Due to the in vitro inactivation of the aminoglycoside by β-lactam antibiotics, piperacillin/tazobactam and the aminoglycoside are recommended for separate administration. Piperacillin/tazobactam and the aminoglycoside should be reconstituted and diluted separately when concomitant therapy with aminoglycosides is indicated (see Incompatibilities under Cautions for Usage).
In circumstances where co-administration is preferred, piperacillin/tazobactam containing EDTA supplied in vials is compatible for simultaneous co-administration via Y-site infusion only with the following aminoglycosides under the following conditions: (See Table 8.)

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Compatibility of piperacillin/tazobactam with other aminoglycosides has not been established. Only the concentration and diluents for amikacin and gentamicin with the dosages of piperacillin/tazobactam listed in the table previously mentioned have been established as compatible for co-administration via Y-site infusion. Simultaneous co-administration via Y-site infusion in any manner other than listed previously may result in inactivation of the aminoglycoside by piperacillin/tazobactam.
Geriatric Population: Patients over 65 years are not at an increased risk of developing adverse effects solely because of age. However, dosage should be adjusted in the presence of renal insufficiency.