From the FDA Drug Label
Dosage in Renal Impairment Creatinine Clearance mL/min Urinary Tract Infection (uncomplicated) Urinary Tract Infection (complicated) Serious Systemic Infection
40 No dosage adjustment necessary 20-40 No dosage adjustment necessary 9 g/day 3 g every 8 h 12 g/day 4 g every 8 h <20 6 g/day 3 g every 12 h 6 g/day 3 g every 12 h 8 g/day 4 g every 12 h For patients on hemodialysis, the maximum daily dose is 6 g/day (2 g every 8 hours).
Yes, Tazocin (piperacillin/tazobactam) requires dosage adjustment in patients with impaired renal function, as indicated by Glomerular Filtration Rate (GFR). The dosage adjustment is based on the creatinine clearance, with specific recommendations for different levels of renal impairment. 1
From the Research
Tazocin (piperacillin/tazobactam) does require dose adjustment based on glomerular filtration rate (GFR). For patients with normal renal function (GFR >40 mL/min), the standard dose is 4.5g every 6-8 hours. For moderate renal impairment (GFR 20-40 mL/min), the dose should be reduced to 4.5g every 8 hours. In severe renal impairment (GFR <20 mL/min), the dose should be further reduced to 4.5g every 12 hours. For patients on hemodialysis, an additional dose should be administered after each dialysis session. These adjustments are necessary because piperacillin and tazobactam are primarily eliminated by the kidneys, and reduced renal function leads to drug accumulation, potentially causing toxicity. Without appropriate dose adjustments, patients with renal impairment may experience adverse effects including neurotoxicity, seizures, and electrolyte disturbances. Regular monitoring of renal function is recommended during Tazocin therapy, especially in critically ill patients whose renal function may fluctuate 2.
Key Considerations
- The estimated glomerular filtration rate (eGFR) can be used to guide dose adjustment in patients with stable kidney function 2.
- Close monitoring of drug effect and toxicity is also needed and can be supported by therapeutic drug monitoring 2.
- Alternative methods for quantifying kidney function include the Cockcroft-Gault formula or direct measures of glomerular filtration rate using exogenous isotope compounds 2.
- Clinical pharmacist-led medication dose adjustment is required to provide safe and effective pharmacotherapy in patients with impaired renal function 3.
Dosing Recommendations
- For patients with normal renal function (GFR >40 mL/min), the standard dose is 4.5g every 6-8 hours.
- For moderate renal impairment (GFR 20-40 mL/min), the dose should be reduced to 4.5g every 8 hours.
- In severe renal impairment (GFR <20 mL/min), the dose should be further reduced to 4.5g every 12 hours.
- For patients on hemodialysis, an additional dose should be administered after each dialysis session.