Piptam Special Precautions

Hepatic, renal and hematologic systems should be evaluated periodically during prolonged therapy with Piperacillin/Tazobactam; monitoring hematopoietic function is especially important when the duration of therapy is 21 days or longer.
Serum electrolytes should be monitored when Piperacillin/Tazobactam is used in patients with low potassium reserves, and the possibility of hypokalemia should be considered when the drug is used in patients who have potentially low potassium reserves and who are receiving concomitant medications that may lower potassium levels.
Piperacillin/Tazobactam should be considered when the drug is administered to patients whose sodium intake is a restriction.
The diarrhea is a common problem caused by anti-infectives and usually ends when the drug is discontinued (CDAD, also known as antibiotic associated diarrhea and colitis or pseudomembranous colitis); however it is important to contact a clinician if watery and bloody stools occur during or as late as 2 months or longer after the last dose.
Bleeding complications could occur during therapy with Piperacillin/Tazobactam, especially when the drug is used in patients with renal impairment. If bleeding manifestations occur, the drug should be discontinued.
Piperacillin/Tazobactam should only be used to treat bacterial infections and not used to treat viral infection.
Patients also should be advised about the importance of completing the full course of therapy, skipping dose or not completing therapy may decrease effectiveness and increase the likelihood that bacteria will develop resistance and will not be treatable with Piperacillin/Tazobactam or other antibacterials in the future.
Use of anti-infective agents, with Piperacillin/Tazobactam may result in overgrowth of nonsusceptible organisms. If superinfection occurs the drug should be discontinued and appropriate therapy initiated.
Serum concentrations of Piperacillin/Tazobactam are higher and prolonged in patients with renal impairment, dose and/or frequency of administration of Piperacillin/Tazobactam should be decreased.
Prior to initiation of therapy with Piperacillin sodium and Tazobactam sodium should be a concern because there is clinical and laboratory evidence of partial cross-allergenicity among penicillin and other β-lactam antibiotic.
Leukopenia and neutropenia may occur; appears to be reversible and most frequently associated with prolonged administration, monitoring recommended.
High doses of Piperacillin/Tazobactam are administered, neurological complications in the form of convulsions may occur.
Serious skin reactions, including toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome (SJS), acute generalized exanthematous, and drug reaction with eosinophilia and systemic symptoms (DRESS) have been reported. If a skin rash develops, monitor closely. Discontinue if lesions progress.