Can Zosyn be given with D5W?
Yes, Zosyn (piperacillin-tazobactam) is compatible with 5% dextrose (D5W) and can be safely administered in this diluent. 1
FDA-Approved Compatibility
The FDA drug label explicitly lists 5% dextrose as an acceptable diluent for Zosyn administration 1. This is particularly relevant when co-administering with aminoglycosides via Y-site, where both 0.9% sodium chloride and 5% dextrose are listed as compatible diluents 1.
Stability Data
Research confirms excellent stability of piperacillin-tazobactam in D5W:
- At room temperature (23-25°C): Solutions remain stable for 2 days with >94% drug retention 2, 3
- Under refrigeration (5°C): Solutions maintain stability for 28 days with >95% drug retention, followed by an additional 72 hours at room temperature 2, 3
- Solutions remain clear and colorless throughout storage, with only minimal pH changes 2, 3
Practical Considerations
Concentration ranges tested and validated:
Administration guidelines:
- Infuse over at least 30 minutes 1
- During infusion, it is desirable to discontinue the primary infusion solution 1
- Visually inspect for particulate matter and discoloration before administration 1
Important Caveats
Y-site compatibility: When co-administering with aminoglycosides via Y-site, D5W is compatible for amikacin and gentamicin at specified concentrations 1. However, 24 other drugs showed incompatibilities with piperacillin-tazobactam in D5W, including increased turbidity, precipitation, or color changes 4.
Bottom line: D5W is a fully acceptable and stable diluent for Zosyn administration, with FDA approval and robust stability data supporting its use in clinical practice.