From the Guidelines
The recommended dose of Zosyn (piperacillin/tazobactam) for a 13 kg child with appendicitis is 200-300 mg/kg/day of the piperacillin component, which can be administered every 6-8 hours. According to the guidelines by the Surgical Infection Society and the Infectious Diseases Society of America 1, the dosage for piperacillin-tazobactam in pediatric patients is 200-300 mg/kg/day of the piperacillin component.
For a 13 kg child, the dose would be:
- 200 mg/kg/day: 13 kg x 200 mg/kg = 2,600 mg of piperacillin per day
- 300 mg/kg/day: 13 kg x 300 mg/kg = 3,900 mg of piperacillin per day
This can be divided into doses administered every 6-8 hours.
- For 200 mg/kg/day: 2,600 mg / 3-4 doses per day = approximately 867-867 mg of piperacillin per dose (or around 1.1 grams of Zosyn per dose, considering the combination)
- For 300 mg/kg/day: 3,900 mg / 3-4 doses per day = approximately 1,300-1,300 mg of piperacillin per dose (or around 1.6 grams of Zosyn per dose)
It's crucial to monitor renal function during treatment, as dose adjustments may be necessary for impaired kidney function 1. The combination of piperacillin with tazobactam provides broad-spectrum coverage against many gram-positive, gram-negative, and anaerobic bacteria commonly involved in intra-abdominal infections like appendicitis. Common side effects include diarrhea, headache, and potential for allergic reactions, especially in patients with penicillin allergies.
Key considerations for treatment include:
- Monitoring for signs of infection resolution or complications
- Potential transition to oral antibiotics once the child shows clinical improvement (afebrile for 24-48 hours with normalized white blood cell count)
- Duration of treatment typically ranges from 5-7 days, depending on clinical response and the presence of any complications like abscesses.
From the FDA Drug Label
• Pediatric Patients by Indication and Age: See Table below (2. 5) Recommended Dosage of Piperacillin and Tazobactam for Injection for Pediatric Patients 2 months of Age and Older, Weighing up to 40 kg and With Normal Renal Function Age Appendicitis and /or Peritonitis 2 months to 9 months 90 mg/kg (80 mg piperacillin and 10 mg tazobactam) every 8 (eight) hours Older than 9 months 112.5 mg/kg (100 mg piperacillin and 12.5 mg tazobactam) every 8 (eight) hours
The recommended dose of Zosyn (piperacillin/tazobactam) for a 13 kg child with appendicitis is 112.5 mg/kg (100 mg piperacillin and 12.5 mg tazobactam) every 8 hours, since the child is older than 9 months 2.
From the Research
Zosyn Dose for a 13 kg Child with Appendicitis
The recommended dose of Zosyn (piperacillin/tazobactam) for pediatric patients is typically based on the piperacillin component, with a dose range of 100-150 mg/kg/day divided into 4-6 doses 3. However, the exact dose for a 13 kg child with appendicitis is not explicitly stated in the provided studies.
Considerations for Dosing
- A study on premature infants suggests that piperacillin should be given in slightly higher doses, 200-300 mg/kg, due to the danger of underdosage as a result of increasing maturation of elimination during the period of treatment 4.
- Another study on children's hospitals found that an extended-infusion piperacillin/tazobactam dosing strategy was feasible, with a median dose of 100 mg/kg based on the piperacillin component 3.
- The choice of antibiotic therapy for appendicitis is controversial, and some studies suggest that antibiotics such as piperacillin/tazobactam may be effective as first-line therapy for acute appendicitis 5.
Key Points to Consider
- The dose of Zosyn for a 13 kg child with appendicitis may be around 100-150 mg/kg/day, divided into 4-6 doses, based on the piperacillin component.
- The feasibility of an extended-infusion piperacillin/tazobactam dosing strategy has been demonstrated in children's hospitals.
- Antibiotic therapy, including piperacillin/tazobactam, may be effective as first-line therapy for acute appendicitis, but the optimal regimen remains unclear 6, 7.