Recommended Dosage of Piperacillin + Tazobactam for Adults
The standard recommended dose of piperacillin/tazobactam for adults with serious infections is 4.5 g administered intravenously every 6 hours (totaling 18 g per day). 1, 2
Dosing Based on Infection Type
Standard Infections
- For most infections (intra-abdominal, skin and soft tissue, female pelvic infections, community-acquired pneumonia), the recommended dose is 3.375 g IV every 6 hours (13.5 g total daily dose) 1
- For more severe infections, increase to 4.5 g IV every 6 hours 2
Hospital-Acquired/Ventilator-Associated Pneumonia
- For nosocomial pneumonia, the recommended dose is 4.5 g IV every 6 hours 3, 1
- When treating Pseudomonas aeruginosa in nosocomial pneumonia, combine with an aminoglycoside 1
Complicated Intra-abdominal Infections
- For complicated intra-abdominal infections, use 3.375-4.5 g IV every 6 hours 3, 2
- For appendicitis complicated by rupture or abscess, use 3.375 g IV every 6 hours 1
Dosing in Special Populations
Renal Impairment
- For creatinine clearance 20-40 mL/min: 2.25 g IV every 6 hours (for standard infections) or 3.375 g IV every 6 hours (for nosocomial pneumonia) 1
- For creatinine clearance <20 mL/min: 2.25 g IV every 8 hours (for standard infections) or 2.25 g IV every 6 hours (for nosocomial pneumonia) 1
- For hemodialysis patients: 2.25 g IV every 12 hours (for standard infections) or 2.25 g IV every 8 hours (for nosocomial pneumonia), with an additional 0.75 g after each dialysis session 1
Administration Methods
Standard Administration
- Administer by intravenous infusion over 30 minutes 1
Extended/Continuous Infusion
- For severe infections, consider extended infusion (3-4 hours) or continuous infusion to maintain plasma concentrations above MIC for at least 70% of the dosing interval 3
- Continuous infusion may be particularly beneficial for infections with organisms having high MICs 3
Treatment Duration
Important Considerations
- The maximum daily dose is 18 g (16 g piperacillin/2 g tazobactam) 1, 2
- For critically ill patients with severe infections, maintaining plasma concentrations of piperacillin above MIC for at least 70% of the time increases success rates 3
- Higher doses may be needed for patients with augmented renal clearance (≥120 mL/min) 4
- For life-threatening infections where 100% time above MIC is preferred, continuous infusion may be more appropriate 5