What is another name for Piperacillin (Pip/Taz) (Zosyn)?

Piperacillin-Tazobactam: Alternative Names and Identification

Piperacillin-tazobactam is also known by the brand name Zosyn, and is commonly abbreviated as Pip/Taz in clinical settings. 1

Chemical Composition and Description

Piperacillin-tazobactam is an injectable antibacterial combination product consisting of:

• Piperacillin sodium: A semisynthetic antibacterial derived from D(-)-α-aminobenzyl-penicillin

  • Chemical name: sodium (2S,5R,6R)-6-[(R)-2-(4-ethyl-2,3-dioxo-1-piperazine-carboxamido)-2-phenylacetamido]-3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylate
  • Chemical formula: C23H26N5NaO7S
  • Molecular weight: 539.5

• Tazobactam sodium: A beta-lactamase inhibitor derived from the penicillin nucleus (penicillanic acid sulfone)

  • Chemical name: sodium (2S,3S,5R)-3-methyl-7-oxo-3-(1H-1,2,3-triazol-1-ylmethyl)-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylate-4-dioxide
  • Chemical formula: C10H11N4NaO5S
  • Molecular weight: 322.3 1

Clinical Applications

Piperacillin-tazobactam (Zosyn) is a beta-lactam/beta-lactamase inhibitor combination with a broad spectrum of antibacterial activity that includes:

• Gram-positive bacteria
• Gram-negative bacteria (including many extended-spectrum β-lactamase producers)
• Anaerobic bacteria 2

It is commonly used in the treatment of:

1. Moderate to severe infections, particularly:

   • Febrile neutropenia
   • Hospital-acquired pneumonia
   • Intra-abdominal infections
   • Diabetic foot infections
   • Skin and soft tissue infections 2

2. As a carbapenem-sparing agent in settings with high prevalence of carbapenem-resistant organisms 2

Available Formulations

Zosyn (piperacillin-tazobactam) is available in several premixed frozen solution formulations:

• 2.25 g/50 mL (2 g piperacillin + 250 mg tazobactam)
• 3.375 g/50 mL (3 g piperacillin + 375 mg tazobactam)
• 4.5 g/100 mL (4 g piperacillin + 500 mg tazobactam) 1

Clinical Considerations

• Piperacillin-tazobactam has demonstrated lower mortality rates compared to cefepime in empiric therapy for infections 2
• It is recommended as a first-choice option for treatment of febrile neutropenia in hospitalized patients 2
• In diabetic foot infections, it is recommended for moderate to severe infections, particularly in patients with recent antibiotic exposure 2
• For hospital-acquired pneumonia, it is recommended as part of empiric therapy regimens, especially in patients at high risk of mortality 2

Important Prescribing Considerations

• Dosage adjustment is required in patients with renal impairment
• Contains 2.84 mEq (65 mg) of sodium per gram of piperacillin, which may be clinically important in patients with conditions such as congestive heart failure
• Generally well-tolerated, with gastrointestinal symptoms (particularly diarrhea) being the most common adverse events 1

Remember that piperacillin-tazobactam is an important antibiotic that should be used judiciously to prevent the development of antimicrobial resistance.