From the Guidelines
For bacterial infections, Piperacillin/Tazobactam (Tazact) is generally preferred as a first-line treatment over Cefeperazone for serious infections requiring broad-spectrum coverage. Piperacillin/Tazobactam is typically administered at 3.375-4.5g (3-4g piperacillin/0.375-0.5g tazobactam) intravenously every 6-8 hours for adults with normal renal function, with treatment duration typically 5-14 days depending on infection severity and site, as recommended by 1. This combination provides excellent coverage against many gram-positive, gram-negative, and anaerobic bacteria, including Pseudomonas aeruginosa. Dose adjustments are necessary for patients with renal impairment, with creatinine clearance determining the appropriate dosing interval. Piperacillin/Tazobactam is preferred because tazobactam inhibits beta-lactamase enzymes that would otherwise inactivate piperacillin, making it effective against many resistant organisms. Cefeperazone, a third-generation cephalosporin, has a narrower spectrum and is less commonly used as first-line therapy in current practice, though it may be appropriate in specific situations based on local resistance patterns or patient-specific factors, as noted in 1 and 1.
Some key points to consider when choosing between Piperacillin/Tazobactam and Cefeperazone include:
- The severity and site of the infection
- Local resistance patterns
- Patient-specific factors, such as renal function and allergy history
- The need for broad-spectrum coverage, including activity against Pseudomonas aeruginosa and other resistant organisms, as discussed in 1 and 1.
It's also important to note that the use of carbapenems, such as imipenem/cilastatin, should be limited to preserve their activity against multidrug-resistant infections, as recommended by 1. Newer antibiotics, such as ceftolozane/tazobactam and ceftazidime/avibactam, may also be valuable options for treating infections caused by multidrug-resistant gram-negative bacteria, as noted in 1 and 1.
In terms of specific dosing and treatment duration, the recommendations vary depending on the infection site and severity, as well as the patient's individual factors, such as renal function, as discussed in 1 and 1. However, in general, Piperacillin/Tazobactam is a preferred first-line treatment option for serious bacterial infections requiring broad-spectrum coverage, due to its excellent coverage and efficacy against many resistant organisms, as recommended by 1 and 1.
From the Research
Comparison of Cefeperazone and Tazact (Piperacillin/Tazobactam)
- Cefeperazone and Piperacillin/Tazobactam are both antibiotics used to treat bacterial infections, but there is limited direct comparison between the two in the provided studies.
- A study comparing ceftazidime, carbapenems, and piperacillin-tazobactam as single definitive therapy for Pseudomonas aeruginosa bloodstream infection found no significant difference in mortality, clinical, and microbiological outcomes or adverse events between the three treatments 2.
- Another study compared the antimicrobial activity of ceftolozane-tazobactam and ceftazidime-avibactam against multidrug-resistant isolates of Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, but did not include cefeperazone or piperacillin-tazobactam in the comparison 3.
- The ERACE-PA Global Surveillance Program evaluated the in vitro activity of ceftolozane/tazobactam and ceftazidime/avibactam against a global collection of carbapenem-resistant Pseudomonas aeruginosa, but did not include cefeperazone or piperacillin-tazobactam in the study 4.
Efficacy of Cefeperazone and Tazact (Piperacillin/Tazobactam)
- There is limited information available on the efficacy of cefeperazone compared to piperacillin/tazobactam in the provided studies.
- A study on cefiderocol, a novel siderophore cephalosporin, found it to be effective against serious Gram-negative bacterial infections, including multidrug-resistant strains 5.
- Piperacillin/tazobactam was found to be effective against Pseudomonas aeruginosa bacteremia, with no significant difference in mortality, clinical, and microbiological outcomes or adverse events compared to ceftazidime and carbapenems 2.
Resistance and Susceptibility
- The provided studies suggest that ceftolozane-tazobactam and ceftazidime-avibactam have activity against multidrug-resistant Pseudomonas aeruginosa, including carbapenem-resistant strains 3, 4.
- Piperacillin/tazobactam was found to be susceptible to Pseudomonas aeruginosa, but the study did not provide information on its activity against carbapenem-resistant strains 2.
- Cefeperazone was not included in the comparison of antimicrobial activity in the provided studies.