What is the coverage of Zosyn (Piperacillin/Tazobactam)?

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Last updated: March 4, 2025View editorial policy

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From the Guidelines

Zosyn (piperacillin-tazobactam) provides broad-spectrum coverage of gram-positive, gram-negative, and anaerobic bacteria, including Pseudomonas aeruginosa, Escherichia coli, Klebsiella species, Enterobacter, Proteus mirabilis, Bacteroides fragilis, and many streptococci, making it a suitable option for treating complicated infections like intra-abdominal infections, pneumonia, skin and soft tissue infections, and febrile neutropenia 1.

Key Coverage and Limitations

  • Zosyn's coverage includes:
    • Gram-negative aerobic and facultative bacilli
    • Anaerobic bacteria
    • Certain gram-positive bacteria
  • However, Zosyn does not cover:
    • MRSA
    • Most Enterococcus faecium
    • Extended-spectrum beta-lactamase (ESBL) producing organisms

Clinical Use

  • Zosyn is typically administered intravenously at doses of 3.375g or 4.5g every 6-8 hours, with adjustments needed for patients with renal impairment 1.
  • The drug works by inhibiting bacterial cell wall synthesis, causing bacterial cell death.

Guideline Recommendations

  • The Surgical Infection Society and the Infectious Diseases Society of America recommend Zosyn as an option for empiric therapy in high-risk or severely ill adults with intra-abdominal infections 1.
  • The World Society of Emergency Surgery recommends Zosyn as an option for hospital-acquired intra-abdominal infections in patients with a risk of multidrug-resistant organisms 1.

From the FDA Drug Label

Piperacillin and tazobactam for injection is a combination of piperacillin, a penicillin-class antibacterial and tazobactam, a beta-lactamase inhibitor, indicated for the treatment of: Intra-abdominal infections in adult and pediatric patients 2 months of age and older (1.1) Nosocomial pneumonia in adult and pediatric patients 2 months of age and older (1. 2) Skin and skin structure infections in adults (1.3) Female pelvic infections in adults (1.4) Community-acquired pneumonia in adults (1. 5)

The coverage of Zosyn (Piperacillin/Tazobactam) includes:

  • Intra-abdominal infections
  • Nosocomial pneumonia
  • Skin and skin structure infections
  • Female pelvic infections
  • Community-acquired pneumonia 2

From the Research

Coverage of Zosyn (Piperacillin/Tazobactam)

The coverage of Zosyn (Piperacillin/Tazobactam) includes:

  • Gram-positive aerobic bacteria
  • Gram-negative aerobic bacteria
  • Anaerobic bacteria
  • Beta-lactamase-producing bacteria
  • Some extended-spectrum beta-lactamase-producing Enterobacteriaceae

Specific Pathogens Covered

Some specific pathogens covered by Zosyn (Piperacillin/Tazobactam) include:

  • Escherichia coli
  • Klebsiella pneumoniae
  • Enterobacter species
  • Pseudomonas aeruginosa

Clinical Uses

Zosyn (Piperacillin/Tazobactam) is used to treat a variety of infections, including:

  • Intra-abdominal infections
  • Skin and soft tissue infections
  • Lower respiratory tract infections
  • Complicated urinary tract infections
  • Gynecological infections
  • Febrile neutropenia

Evidence from Studies

Studies have shown that Zosyn (Piperacillin/Tazobactam) is effective against a broad range of pathogens, including those producing beta-lactamases 3, 4, 5, 6, 7. The combination of piperacillin and tazobactam provides a broad spectrum of antibacterial activity, making it a useful option for the treatment of polymicrobial infections 4, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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