Recommended Dilution for Piperacillin-Tazobactam 4.5 g
For piperacillin-tazobactam 4.5 g, reconstitute with 20 mL of compatible diluent, then further dilute to a final volume of 50-150 mL in a compatible IV solution for administration over at least 30 minutes. 1
Reconstitution Process
Step 1: Initial Reconstitution
- Reconstitute the 4.5 g vial with 20 mL of a compatible diluent 1
- This yields a concentration of approximately 202.5 mg/mL (180 mg/mL piperacillin and 22.5 mg/mL tazobactam)
Step 2: Further Dilution
- The reconstituted solution should be further diluted to a final volume of 50-150 mL 1
- This creates a final piperacillin concentration between 20-80 mg/mL (tazobactam between 2.5-10 mg/mL)
Compatible Diluents for Reconstitution
The following solutions can be used for reconstitution 1:
- 0.9% Sodium Chloride for injection
- Sterile Water for injection
- Dextrose 5%
- Bacteriostatic saline/parabens
- Bacteriostatic water/parabens
- Bacteriostatic saline/benzyl alcohol
- Bacteriostatic water/benzyl alcohol
Compatible Solutions for Further Dilution
After reconstitution, the solution can be further diluted with 1:
- 0.9% Sodium Chloride for injection
- Sterile Water for injection (maximum recommended volume per dose is 50 mL)
- Dextrose 5%
Important Compatibility Considerations
- LACTATED RINGER'S SOLUTION IS NOT COMPATIBLE with piperacillin-tazobactam 1
- Do not mix with other drugs in the same syringe or infusion bottle 1
- Not chemically stable in solutions containing only sodium bicarbonate or solutions that significantly alter pH 1
- Should not be added to blood products or albumin hydrolysates 1
Administration Recommendations
- Administer by infusion over a period of at least 30 minutes 1
- During the infusion, it is recommended to discontinue the primary infusion solution 1
- For critically ill patients with septic shock or high severity scores, consider prolonged or continuous infusions to improve clinical cure rates 2
Special Considerations for Extended/Continuous Infusions
- Extended infusions (3-4 hours) or continuous infusions may improve pharmacodynamic target attainment, especially for resistant organisms 2
- Studies show that continuous infusion of piperacillin-tazobactam achieves 100% fT>MIC compared to only 50% fT>MIC with standard intermittent dosing 2
- For patients with septic shock, extended infusions may improve clinical outcomes 2
Stability Information
- Single-dose vials should be used immediately after reconstitution 1
- If not used immediately, reconstituted solution can be stored:
- Up to 24 hours at room temperature (20-25°C or 68-77°F)
- Up to 48 hours when refrigerated (2-8°C or 36-46°F)
- Diluted solution in IV bags has demonstrated chemical stability for up to 24 hours at room temperature and up to one week when refrigerated 1
Aminoglycoside Compatibility
Due to in vitro inactivation of aminoglycosides by piperacillin, separate administration is recommended. If co-administration via Y-site is necessary, compatibility has been established only under specific conditions with amikacin and gentamicin 1.
Remember that proper dilution and administration techniques are crucial for achieving optimal therapeutic outcomes and reducing the risk of adverse effects when using piperacillin-tazobactam.