Does Zosyn (piperacillin-tazobactam) cause QTc interval prolongation?

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Last updated: March 30, 2025View editorial policy

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From the Research

Zosyn (piperacillin-tazobactam) is associated with QTc prolongation, as indicated by a study published in 2016 1, which found that piperacillin + tazobactam was one of the drugs that prolonged QTc at univariate analysis. However, it's essential to consider the overall risk-benefit ratio and the fact that many other factors, including patient-related risk factors and concomitant medications, play a more significant role in QTc prolongation 2. The risk of QTc prolongation with Zosyn should be weighed against the benefits of using this antibiotic, especially in patients with severe infections. Some key points to consider when administering Zosyn include:

  • Monitoring electrolytes and correcting any imbalances, especially in critically ill patients, as electrolyte abnormalities can independently contribute to QT prolongation 3, 4.
  • Being aware of other medications that may prolong the QT interval and avoiding concomitant use when possible 2, 5.
  • Considering alternative antibiotics if the patient has significant risk factors for QTc prolongation or is taking other medications that may prolong the QT interval. The standard dosing of Zosyn (typically 3.375g or 4.5g IV every 6-8 hours, adjusted for renal function) can be used, but with careful consideration of the patient's individual risk factors and close monitoring for signs of QTc prolongation. It's also important to note that the actual prevalence of drug-induced QTc prolongation in clinical practice is unknown, and more research is needed to fully understand the risks and benefits of using Zosyn in patients with risk factors for QTc prolongation 1.

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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