Uses of Piperbact

1 vial of Piperbact powder for injection contains 4g Piperacillin Sodium and 0.5g Tazobactam Sodium. Piperacillin is a semi-synthetic penicillin antibiotic with a broad spectrum of activity against gram-negative and gram-positive aerobic and anaerobic bacteria. Piperacillin has a mechanism of action by inhibiting cell wall and cell synthesis.
Tazobactam is a triazolylmethyl penicillanic acid sulphone, a potent inhibitor of many beta-lactamases, especially plasmid-mediated enzymes (a common cause of resistance to penicillins and cephalosporins). The presence of Tazobactam increases the antibacterial spectrum of Piperacillin, including beta-lactamase-producing bacteria that are resistant to other beta-lactam antibiotics. Therefore, Piperbact is a combination of the action of a broad-spectrum antibiotic with a beta-lactamase inhibitor.
Piperacillin and Tazobactam combination is especially useful when used in the treatment of mixed infections and in the treatment of containment before antibiogram results are available (because this drug has a very broad spectrum of activity).
Indications for use of Piperbact:
Treatment of systemic or local infections, identified or suspected to be caused by susceptible bacteria: Complicated urinary tract infections, lower respiratory tract infections , skin and soft tissue infections, intra-abdominal infections, sepsis, obstetric and gynecological infections, polymicrobial infections; Piperacillin/Tazobactam has a synergistic effect on aminoglycosides against certain strains of Pseudomonas aeruginosa. There has been success when using combination therapy, especially in patients with impaired resistance. As soon as the antibiogram results are available, an adjustment of antibiotic therapy should be made. Contraindications to the use of Pirbact:
Patients with a history of allergy to Piperacillin, cephalosporins or to beta-lactamase inhibitors.

How to use:
Intravenous injection: Mix each vial of 4.5g with 20ml of sterile distilled water or 0.9% NaCl, inject slowly for about 3-5 minutes; Intravenous infusion: Mix each vial of 4.5g with 20ml of sterile distilled water or 0.9% NaCl, then further dilute to at least 50ml, slow intravenous infusion over about 20-30 minutes. Storage:
Piperacillin/Tazobactam lyophilized powder vials can be stored at controlled room temperature (15-25°C) for up to 3 years; When properly mixed, Piperacillin/Tazobactam is stable for 24 hours if stored in a refrigerator at 2-8°C and in an infusion bag or syringe. Reconstituted drugs that are not used must be discarded; Piperacillin/Tazobactam must not be mixed with other antibiotics in the same syringe or in the same bottle of infusion. Dosage:
People 12 years of age and older: Use a dose of 4g Piperacillin/0.5g Tazobactam intravenously every 8 hours. The total daily dose may vary from 2.25 - 4.5 g every 6 - 8 hours; Children under 12 years of age: There are currently no data on the use of the drug in this group of subjects; Patients with renal impairment: The dose of Piperacillin/Tazobactam should be adjusted according to creatinine clearance. Specifically: Creatinine clearance 20 - 80ml/min: Use dose 12g/1.5g/day, divided into 4g/0.5g every 8 hours; Creatinine clearance less than 20ml/min: Use dose of 8g/1g/day, divided into 4g/0.5g every 12 hours; Patients on hemodialysis: The maximum total daily dose of Piperacillin/Tazobactam is 8g/1g; Because a 4-hour dialysis cycle can remove about 30-50% of Piperacillin, after each dialysis cycle, an additional 2g/0.25g Piperacillin/Tazobactam is required. Duration of treatment: For acute infections, Piperbact should be continued for at least 48 hours after the patient's fever is gone or all clinical symptoms have resolved.
Overdose: There is currently no experience in the management of Piperacillin/Tazobactam overdose. However, in case of emergency, the patient will be prescribed the same intensive medical measures as the treatment of Piperacillin overdose. If the serum piperacillin concentration is too high, the patient may be on dialysis.
However, doses of Piperacillin up to 24g/day have not been reported to cause adverse side effects. In cases where the patient has motor agitation or convulsions, an anticonvulsant such as diazepam or a barbiturate can be used. In case of severe anaphylactic shock, immediate treatment measures should be taken.
In case of severe and prolonged diarrhea, the patient should consider the possibility of pseudomembranous colitis. At this point, Piperacillin/Tazobactam should be discontinued and appropriate therapy initiated, eg oral teicoplanin or oral vancomycin. At the same time, drugs that inhibit intestinal motility should not be given to patients.

When using Piperbact, patients may experience some side effects such as:
Local: phlebitis, thrombophlebitis. The patient may have inflammation or pain at the injection site due to not mixing the medicine as directed; Common systemic: Diarrhea, erythema, rash, itchy skin, nausea, vomiting, urticaria, allergic reactions, superinfection; Rare systemic: Skin reactions, muscle weakness, sweating, eczema, erythema multiforme, exanthema, maculopapular rash, constipation, stomatitis, dry mouth, hallucinations, myalgia, hypotension pressure, fever, superficial phlebitis, edema, flushing, fatigue; Laboratory tests: Transient decrease in white blood cell count, thrombocytosis, eosinophilia, thrombocytopenia, hypokalemia, positive Coombs test, transient elevation of liver enzymes (SGOT, SGPT, alkaline phosphatase) in blood serum, increased bilirubin, increased renal function parameters (urea, creatinine) in the serum. When experiencing side effects of Piperbact, patients should promptly notify their doctor to receive appropriate advice on the best intervention and response measures.

Before starting treatment with Piperacillin/Tazobactam, the patient should carefully discuss with the doctor about the history of allergy to penicillins, cephalosporins or other allergies. other source. If an allergic reaction occurs during treatment with Piperacillin/Tazobactam, the patient should stop taking the drug. For severe hypersensitivity reactions, the patient may require adrenaline and other emergency measures; Although Piperacillin/Tazobactam has a low toxicity characteristic of penicillin antibiotics, users should still periodically check liver, kidney and hematopoietic function if taking for a long time; Bleeding has occurred in some patients treated with beta-lactam antibiotics. These reactions sometimes occur in association with abnormalities on coagulation tests such as platelet aggregation, clotting time, and prothrombin time and are more common in patients with renal failure. If bleeding occurs as a result of antibiotic therapy, the patient should immediately stop Piperbact and institute appropriate therapy; When using Piperacillin/Tazobactam, patients should be aware of the possibility of drug-resistant bacteria, especially when using the drug for a long time. If superinfection occurs due to resistant bacteria, appropriate management interventions are required; If the patient uses Piperacillin/Tazobactam at a higher dose than the recommended intravenous dose, neuromuscular agitation or convulsions may occur; Cyclic ionography should be performed in patients with low potassium stores, and the possibility of hypokalemia should always be kept in mind in patients with very low potassium stores or in patients being treated with drugs that cause hyperkalemia. cytotoxicity, diuretics,... A slight increase in liver function indexes can be observed in this group of patients; Using high-dose, short-term antibiotics to treat gonorrhea may mask or delay the onset of symptoms of syphilis. Therefore, patients with gonorrhea should be tested for syphilis before being treated with Piperacillin/Tazobactam. Specimens for black-field microscopy may be obtained from any primary lesion. With serological tests, it is necessary to wait at least 4 months; There are no adequate studies on the use of Piperacillin/Tazobactam in pregnant and lactating women. It is best that this group of subjects should not use the drug, only use it if it is approved by a doctor after carefully weighing the benefits and risks; It is not known whether the use of Piperacillin/Tazobactam on the ability to drive or operate machinery is unknown. It is best for this subject to be cautious when using the drug.

Some drug interactions of Piperbact include:
Concomitant administration of Piperacillin/Tazobactam with probenecid increased the half-life and clearance rate of Piperacillin and also Tazobactam but did not affect the peak plasma concentrations of the drugs. this component; Drug interactions between Piperacillin/Tazobactam and tobramycin or vancomycin are unknown; When combining Piperacillin/Tazobactam with another drug, it should not be mixed in the same vial or injected at the same time to avoid the risk of physical incompatibility; When Piperacillin/Tazobactam is used concurrently with high-dose heparin, oral anticoagulants or drugs that can affect the coagulation system, platelet function, etc., it is necessary to regularly measure and monitor carefully. coagulation parameters of the patient. When prescribed Piperbact, patients should follow and coordinate with all detailed instructions of the doctor. Patients also need to fully list the drugs and functional foods they are taking to the doctor to be considered for appropriate adjustments, avoiding adverse drug interactions.
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