Piptam Mechanism of Action

Pharmacology: Pharmacodynamics: Piperacillin sodium, a broad spectrum, semisynthetic penicillin active against many gram-positive and gram-negative aerobic and anaerobic bacteria. Piperacillin sodium is bactericidal; the drug inhibits bacterial cell wall synthesis by binding to one or more of penicillin binding proteins (PBPs); which turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls.
Tazobactam sodium inhibits many β-lactamases, including staphylococcal penicillinase. Tazobactam is a β-lactamase inhibitor and synergistically expands the spectrum of activity of Piperacillin sodium against β-lactamase-producing bacteria by irreversibly and completely inhibiting β-lactamase.
Piperacillin/Tazobactam are active in vitro against the following bacteria.
Gram-negative bacteria: Acinetobacter baumannii, Citrobacter koseri, Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Morganella morganii, Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Proteus mirabilis, Proteus vulgaris, Providencia rettgeri, Pseudomonas aeruginosa, Salmonella enterica, Serratia marcescens.
Gram-positive bacteria: Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans.
Anaerobic bacteria: Bacteroides spp, Clostridium perfringens.
Pharmacokinetics: Peak plasma concentration of Piperacillin/Tazobactam are attained immediately after completion of IV infusion.
Piperacillin plasma concentrations attained with the fixed-combination preparation of Piperacillin/Tazobactam are similar to those attained with equivalent doses of Piperacillin administered alone.
Both Piperacillin and Tazobactam are widely distributed into tissues and body fluid, including intestinal mucosa, gallbladder, lung, female reproductive tissues (uterus, ovary, fallopian tube), interstitial fluid, bile, and cross the placenta. Piperacillin is distributed into milk. Low concentrations of Piperacillin/Tazobactam are distributed into CSF. Both Piperacillin and Tazobactam are approximately 30% bound to plasma proteins in adults.
Piperacillin is metabolized to a minor microbiological active desethyl metabolite. Tazobactam is metabolized to a single metabolite that lacks pharmacologic and antibacterial activity.
In adults, 68% of a Piperacillin dose is eliminated unchanged in the urine, 10-20% in feces and 80% of a Tazobactam dose is eliminated unchanged in the urine, half-lives of Piperacillin and plasma half-lives of Tazobactam range from 0.7-1.2 hours, the half-lives of Piperacillin/Tazobactam are increased by approximately 25% and 18% respectively with cirrhosis. In the renal impairment half-lives of Piperacillin/Tazobactam increase with decreasing creatinine clearance.