Indications for Piperacillin:
Serious susceptible infections, including lower respiratory tract, intraabdominal, septicemia, skin and skin structure, bone and joint, UTIs, gynecological infections, and uncomplicated gonoccocal urethritis. Surgical prophylaxis in intraabdominal (GI and biliary) procedures, vaginal and abdominal hysterectomy, and cesarean section.
Give by IM inj into upper outer quadrant of buttock; or IV inj over 3–5 minutes; or IV infusion over 20–30 minutes. Max dose: 24g/day. IM inj: max 2g per injection site. May give 1g probenecid orally ½ hour prior to inj. Serious infections: 12–18g/day IV (200–300mg/kg/day) in divided doses every 4–6 hours. Complicated UTIs: 8–16g/day IV (125–200mg/kg/day) in divided doses every 6–8 hours. Uncomplicated UTIs and community-acquired pneumonia: 6–8g/day IM or IV (100–125mg/kg/day) in divided doses every 6–12 hours. Uncomplicated gonorrhea infections: 2g IM once as a single dose. All: treat for 7–10 days; gynecological infections: 3–10 days; Streptococcus pyogenes infections: at least 10 days. Acute infections: continue therapy 48–72 hours after patient becomes asymptomatic. Prophylaxis, renal impairment, or hemodialysis: see literature.
Beta-lactam allergy including cephalosporins.
Renal impairment. Salt-restricted. Monitor renal, hepatic, hematopoietic function in prolonged use. Discontinue if bleeding disorder occurs. Cystic fibrosis (increased fever/rash risk). Gonorrhea infections: do serologic test for syphilis at baseline and 3 months after therapy. Pregnancy (Cat.B). Nursing mothers.
Potentiated by probenecid. Antagonizes aminoglycosides. May potentiate non-depolarizing muscle relaxants (eg, vercuronium). Monitor methotrexate, heparin, anticoagulants. May cause false (+) with Clinitest, Benedict's or Fehling's soln, Coomb's test.
Inj site reactions, GI disturbances, rash (may be severe, eg, Stevens-Johnson syndrome), headache, dizziness, fatigue, seizures, renal impairment, anaphylaxis, blood dyscrasias, bleeding.
Formerly known under the brand name Pipracil.