From the Research
Zosyn (piperacillin-tazobactam) has been associated with QTc interval prolongation, although the evidence is not strong, and it is not considered a high-risk medication for QT prolongation. According to a study published in 2016 1, piperacillin + tazobactam was found to prolong the QTc interval in a multicenter study. However, this study did not provide conclusive evidence of the risk of QTc interval prolongation associated with Zosyn.
Key Points to Consider
- The study published in 2016 1 found that piperacillin + tazobactam was associated with QTc interval prolongation, but the evidence is not strong.
- Other studies, such as the one published in 2020 2, did not investigate the effect of Zosyn on QTc interval prolongation.
- The study published in 2024 3 reported a rare case of myocardial injury with heart failure following treatment with piperacillin-tazobactam, but this does not provide conclusive evidence of the risk of QTc interval prolongation.
- The study published in 2014 4 and 2001 5 did not investigate the effect of Zosyn on QTc interval prolongation.
Clinical Implications
- Caution should be exercised when using Zosyn in patients with multiple risk factors for QT prolongation, such as electrolyte abnormalities (particularly hypokalemia or hypomagnesemia), congenital long QT syndrome, or concomitant use of other QT-prolonging drugs.
- Standard dosing of Zosyn (typically 3.375g or 4.5g IV every 6-8 hours, adjusted for renal function) can generally be administered without specific QT monitoring in most patients without these risk factors.
- However, monitoring of QTc interval may be considered in patients with risk factors for QT prolongation.