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What is Piperacillin
Piperacillin is a parenteral, semisynthetic, extended-spectrum acylureidopenicillin.
Extended-spectrum penicillins, such as piperacillin, are used mainly in the treatment of serious, gram-negative infections and in combination with an aminoglycoside to treat systemic Pseudomonas infections.
Clinically, piperacillin is used to treat intra-abdominal infections, respiratory and urinary tract infections, skin and soft-tissue infections, and other infections caused by susceptible organisms.
Piperacillin was approved by the FDA in 1981. Wyeth-Lederle discontinued marketing Pipracil® of piperacillin injection in 2002.
In November 2003, a new generic piperacillin product was FDA-approved.
Indications
- Acinetobacter sp.
- Actinomyces sp.
- Bacillus anthracis
- bacteremia
- Bacteroides fragilis
- Bacteroides sp.
- Bacteroides vulgatus
- Bifidobacterium sp.
- bone and joint infections
- Brevundimonas vesicularis
- Burkholderia cepacia
- Citrobacter diversus
- Citrobacter freundii
- Clostridium sp.
- community-acquired pneumonia
- Eikenella corrodens
- endometritis
- Enterobacter sp.
- Enterococcus faecalis
- Enterococcus sp.
- Escherichia coli
- Eubacterium sp.
- Flavobacterium sp.
- Fusobacterium necrophorum
- Fusobacterium nucleatum
- gonorrhea
- gynecologic infections
- Haemophilus influenzae (beta-lactamase negative)
- Haemophilus parainfluenzae
- intraabdominal infections
- Klebsiella sp.
- Lactobacillus sp.
- lower respiratory tract infections
- Moraxella sp.
- Morganella morganii
- Neisseria gonorrhoeae
- Neisseria meningitidis
- nosocomial pneumonia
- pelvic cellulitis
- pelvic inflammatory disease (PID)
- Peptococcus sp.
- Peptostreptococcus sp.
- pneumonia
- Porphyromonas asaccharolytica
- Prevotella melaninogenica
- Propionibacterium sp.
- Proteus mirabilis
- Proteus vulgaris
- Providencia rettgeri
- Providencia stuartii
- Pseudomonas aeruginosa
- Pseudomonas fluorescens
- Pseudomonas stutzeri
- Salmonella sp.
- sepsis
- Serratia sp.
- Shigella sp.
- skin and skin structure infections
- Stenotrophomonas maltophilia
- Streptococcus agalactiae (group B streptococci)
- Streptococcus bovis
- Streptococcus dysgalactiae
- Streptococcus pneumoniae
- Streptococcus pyogenes (group A beta-hemolytic streptococci)
- surgical infection prophylaxis
- urinary tract infection (UTI)
- Veillonella sp.
- Viridans streptococci
- Yersinia enterocolitica
Side Effects
- agranulocytosis
- anaphylactic shock
- anaphylactoid reactions
- angioedema
- bleeding
- candidiasis
- diarrhea
- dizziness
- ecchymosis
- elevated hepatic enzymes
- eosinophilia
- erythema
- erythema multiforme
- fatigue
- fever
- headache
- hematoma
- hemolytic anemia
- hepatitis
- hyperbilirubinemia
- hypokalemia
- injection site reaction
- interstitial nephritis
- leukopenia
- nausea
- neutropenia
- pancytopenia
- phlebitis
- platelet dysfunction
- prolonged bleeding time
- pruritus
- pseudomembranous colitis
- rash
- renal failure (unspecified)
- seizures
- Stevens-Johnson syndrome
- superinfection
- thrombocytopenia
- thrombosis
- toxic epidermal necrolysis
- urticaria
- vesicular rash
- vomiting
Monitoring Parameters
- LFTs
- serum creatinine/BUN
- serum potassium
Contraindications
- anticoagulant therapy
- asthma
- biliary obstruction
- breast-feeding
- carbapenem hypersensitivity
- cephalosporin hypersensitivity
- children
- coagulopathy
- colitis
- cystic fibrosis
- diabetes mellitus
- diarrhea
- eczema
- electrolyte imbalance
- geriatric
- GI disease
- hemophilia
- hypokalemia
- infants
- inflammatory bowel disease
- neonates
- penicillin hypersensitivity
- pregnancy
- pseudomembranous colitis
- renal failure
- renal impairment
- sexually transmitted disease
- sodium restriction
- ulcerative colitis
Interactions
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Anticoagulants
- Antithrombin III
- Apixaban
- Argatroban
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atracurium
- Betrixaban
- Bivalirudin
- Choline Salicylate; Magnesium Salicylate
- Cisatracurium
- Colchicine; Probenecid
- Dabigatran
- Dalteparin
- Danaparoid
- Desirudin
- Digoxin
- Edoxaban
- Enoxaparin
- Erythromycin; Sulfisoxazole
- Ethacrynic Acid
- Fondaparinux
- Furosemide
- Heparin
- Indomethacin
- Lepirudin
- Magnesium Salicylate
- Methotrexate
- Mivacurium
- Oral Contraceptives
- Pancuronium
- Pentosan
- Probenecid
- Pyrimethamine; Sulfadoxine
- Rivaroxaban
- Rocuronium
- Salsalate
- Sodium Benzoate; Sodium Phenylacetate
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Sulfadiazine
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfasalazine
- Sulfisoxazole
- Sulfonamides
- Tetracyclines
- Tinzaparin
- Typhoid Vaccine
- Vancomycin
- Vecuronium
- Warfarin
