What is the dosage and treatment duration for Zosyn (piperacillin/tazobactam) in adults with bacterial infections?

From the Guidelines

Zosyn (piperacillin/tazobactam) should be dosed at 3.375g (3g piperacillin/0.375g tazobactam) administered intravenously every 6 hours for most adult infections, with a possible increase to 4.5g (4g piperacillin/0.5g tazobactam) every 6 hours for more severe infections, such as nosocomial pneumonia, as recommended by the most recent guidelines 1.

Key Considerations

• The standard treatment duration is 7-14 days, depending on the type and severity of infection, with complicated intra-abdominal infections often requiring 5-14 days and nosocomial pneumonia typically needing 7-14 days of therapy.
• Dosage adjustments are necessary for patients with renal impairment; for creatinine clearance 20-40 mL/min, the recommended dose is 2.25g every 6 hours, and for clearance below 20 mL/min, 2.25g every 8 hours is appropriate, as indicated in the guidelines for the treatment of infections due to multidrug-resistant organisms 1.
• Each dose should be infused over 30 minutes.
• Treatment should continue until clinical signs of infection have resolved, typically for at least 48 hours after the patient becomes afebrile.

Spectrum of Activity

• Zosyn provides broad-spectrum coverage against many gram-positive, gram-negative, and anaerobic bacteria by inhibiting cell wall synthesis, making it effective for complicated skin infections, intra-abdominal infections, pneumonia, and urinary tract infections, as supported by the recommendations for the treatment of infections due to multidrug-resistant organisms 1.

Important Notes

• The dosage and treatment duration may vary depending on the specific type and severity of infection, as well as the patient's renal function and other factors, as outlined in the guidelines for the diagnosis and management of skin and soft tissue infections 1.
• It is essential to consult the most recent guidelines and evidence-based recommendations for the treatment of specific infections, such as those provided by the Infectious Diseases Society of America and other reputable organizations 1.

From the FDA Drug Label

DOSAGE RECOMMENDATIONS Type of InfectionUsual Total Daily Dose † Serious infections such as septicemia, nosocomial pneumonia, intra-abdominal infections, aerobic and anaerobic gynecologic infections, and skin and soft tissue infections 12 – 18 g/d I.V. (200 – 300 mg/kg/d) in divided doses every 4 to 6 h Complicated urinary tract infections 8 – 16 g/d I. V. (125 – 200 mg/kg/d) in divided doses every 6 to 8 h Uncomplicated urinary tract infections and most community-acquired pneumonia 6 – 8 g/d I.M. or I.V. (100– 125 mg/kg/d) in divided doses every 6 to 12 h The average duration of PIPRACIL treatment is from seven to ten days, except in the treatment of gynecologic infections, which is from three to ten days; the duration should be guided by the patient's clinical and bacteriological progress.

The dosage and treatment duration for Zosyn (piperacillin/tazobactam) in adults with bacterial infections are as follows:

• Serious infections: 12-18 g/day IV in divided doses every 4-6 hours, for 7-10 days.
• Complicated urinary tract infections: 8-16 g/day IV in divided doses every 6-8 hours, for 7-10 days.
• Uncomplicated urinary tract infections and community-acquired pneumonia: 6-8 g/day IM or IV in divided doses every 6-12 hours, for 7-10 days. Treatment duration should be guided by the patient's clinical and bacteriological progress 2.

From the Research

Dosage and Treatment Duration for Zosyn (Piperacillin/Tazobactam)

The dosage and treatment duration for Zosyn (piperacillin/tazobactam) in adults with bacterial infections vary depending on the type and severity of the infection.

• The usual dose of piperacillin/tazobactam is 3-4 g every 4-6 hours as a 20-30 minute infusion, with a maximum dose of 24 g per day 3.
• For skin and soft tissue infections, piperacillin/tazobactam (4 g/500 mg every 8 hours) has been shown to be effective, with a clinical cure or improvement rate of 93% 4.
• In the treatment of complicated urinary tract infections, piperacillin/tazobactam (4 g/500 mg every 8 hours) has been administered for a mean of 9.1 days, with a favorable clinical response rate of 83.6% 5.
• The treatment duration for Zosyn (piperacillin/tazobactam) can range from 5-15 days, depending on the severity and type of infection 6, 5.

Efficacy and Safety of Piperacillin/Tazobactam

Piperacillin/tazobactam has been shown to be effective and safe in the treatment of various bacterial infections, including:

• Skin and soft tissue infections, with a clinical cure or improvement rate of 93% 4.
• Complicated urinary tract infections, with a favorable clinical response rate of 83.6% 5.
• Intra-abdominal infections, with clinical and bacteriological response rates significantly higher than those of imipenem/cilastatin 7.
• The incidence of adverse reactions is similar to that of other treatment regimens, with gastrointestinal symptoms and skin reactions being the most common adverse events 7, 4.