Piptam Dosage/Direction for Use

Mode of administration: PIPTAM 4.5 G INJECTION given by slow intravenous infusion over 30 minutes or slow intravenous injection over 3-5 minutes.
Reconstitution direction for IV injection: Reconstituted PIPTAM 4.5 G INJECTION with one of diluents below 20 mL: 0.9% sodium chloride for injection, sterile water for injection, 5% dextrose injection.
Shake until dissolved. When swirled constantly, reconstitution generally occurs within 5 to 10 minutes.
Solution obtained clear and free from undissolved particles. Intravenous injection should be given over 3-5 minutes.
Reconstitution direction for IV infusion: Reconstituted PIPTAM 4.5 G INJECTION with 20 mL of sterile water for injection then diluted further to the desired volume (50 mL to 150 mL) with one of compatible diluents as follows: 0.9% sodium chloride for injection, sterile water for injection*, 5% dextrose injection.
Shake until dissolved, solution obtained clear and free from undissolved particles and intravenous injection should be given not less than 30 minutes.
* Maximum recommended volume of sterile water for injection per dose is 50 mL.
Avoid administered with aminoglycosides and physical incompatible drug with PIPTAM 4.5 G INJECTION.
Aseptic technique must be used to reduce the risk of contamination during reconstitution. Do not store any unused portion of the IV infusion solution for reuse.
Should be inspected visually for particulate matter or discoloration prior to administration whenever solution and container permit. Solution of Piperacillin/Tazobactam must be clear before administration.
Do not use the same equipment for injection with PIPTAM 4.5 G INJECTION and other medicine and should not be added to blood products or albumin hydrolysates.
Stability after reconstitution: Before reconstitution, store below 30°C. Use single-dose vials immediately after reconstitution.
For solution 20 mL after reconstitution, please follow these: Stable not more than 24 hours store between 20-30°C.
Stable not more than 48 hours store between 2-8°C.
Do not freeze vial after reconstitution.
For diluted solutions (50 mL or 150 mL) in the IV bags, please follow these: Stable not more than 24 hours store between 20-30°C.
Stable not more than 1 week store between 2-8°C.
Recommended dose: Adult and children receiving the adult dosage (weighing greater than 40 kg): The usual dosage of Piperacillin/Tazobactam recommended for adults is 4.5 g (4 g of Piperacillin and 0.5 g of Tazobactam) every 8 hours. For hospital-acquired pneumonia and bacterial infections in neutropenic patients, the recommended dose is 4.5 g (4 g of Piperacillin and 0.5 g of Tazobactam) every 6 hours; maximum: 18 g/day.
Recommended dosage for children patients 2-12 years of age with normal renal function: See Table 1.

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The usual duration of Piperacillin/Tazobactam therapy is 7-10 days (for hospital-acquired pneumonia; 7-14 days). Duration should be based on the severity of the infection and the patient's clinical and bacteriologic progress. For most acute infection, therapy should be continued for at least 48-72 hours after the patient becomes asymptomatic or evidence of eradication of the infection is obtained.
Elderly: Use the same dose level as adults except in cases of renal impairment.
Dosage for patient with renal impairment: Adult: Use dosage recommendation as follows: See Table 2.

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For patients on hemodialysis, the maximum daily dose is 8 g/1 g Piperacillin/Tazobactam. In addition, because hemodialysis removes 30%-50% of Piperacillin in 4 hours, one additional dose of 2 g/250 mg Piperacillin/Tazobactam should be administered following each dialysis period.
Children aged 2-12 years: Use dosage recommendation as follows: See Table 3.

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For children on hemodialysis, one additional dose of 40 mg/5 mg Piperacillin/Tazobactam /kg should be administered following each dialysis period.
Co-administration of Piperacillin/Tazobactam with aminoglycosides: Because of the in vitro inactivation of the aminoglycoside by β-lactam antibiotics, Piperacillin/Tazobactam and aminoglycoside are recommended for separated administration. Piperacillin/Tazobactam and aminoglycoside should be reconstituted, diluted, and administered separately when concomitant therapy with aminoglycosides is indicated.
Hepatitis patients: Not necessitate a change in Piperacillin/Tazobactam dosage in patients with hepatitis impairment and should monitor hepatitis enzyme.