What is the usual dose of intravenous (IV) Tazocin (piperacillin/tazobactam)?

Standard IV Tazocin (Piperacillin/Tazobactam) Dosing

For most serious infections in adults with normal renal function, the usual dose of IV Tazocin is 3.375 g every 6 hours, administered as a 30-minute infusion, totaling 13.5 g daily. 1

Adult Dosing by Indication

Standard Infections (Non-Pneumonia)

• 3.375 g IV every 6 hours for intra-abdominal infections, skin and soft tissue infections, urinary tract infections, and gynecological infections 1, 2
• Administered as 30-minute infusion 1
• Total daily dose: 13.5 g (12 g piperacillin + 1.5 g tazobactam) 1
• Typical duration: 7-10 days 1

Nosocomial Pneumonia (Higher Dose Required)

• 4.5 g IV every 6 hours plus an aminoglycoside for initial empirical treatment 1, 3
• Total daily dose: 18 g (16 g piperacillin + 2 g tazobactam) 1, 3
• Duration: 7-14 days 1
• Continue aminoglycoside if Pseudomonas aeruginosa is isolated 1

Necrotizing Infections

• 3.37 g IV every 6-8 hours combined with vancomycin for mixed infections 4
• Broader coverage needed for polymicrobial etiology 4

Renal Impairment Adjustments

Dosing must be reduced when creatinine clearance ≤40 mL/min to prevent toxicity: 1

• CrCl 20-40 mL/min: 2.25 g every 6 hours (standard infections) or 3.375 g every 6 hours (nosocomial pneumonia) 1
• CrCl <20 mL/min: 2.25 g every 8 hours (standard infections) or 2.25 g every 6 hours (nosocomial pneumonia) 1
• Hemodialysis: 2.25 g every 12 hours (standard) or every 8 hours (pneumonia), plus 0.75 g after each dialysis session 1

Critical pitfall: Higher doses (4.5 g) in patients with renal impairment significantly increase acute kidney injury risk, even with reduced frequency 5. One study found AKI rates of 25-38.5% with 4.5 g dosing in chronic kidney disease patients versus 0-5.6% with 2.25 g dosing 5.

Pediatric Dosing (≥2 Months)

For children weighing ≤40 kg: 1

• Ages 2-9 months: 90 mg/kg (80 mg piperacillin + 10 mg tazobactam) every 8 hours for appendicitis/peritonitis; every 6 hours for nosocomial pneumonia 1
• Ages >9 months: 112.5 mg/kg (100 mg piperacillin + 12.5 mg tazobactam) every 8 hours for appendicitis/peritonitis; every 6 hours for nosocomial pneumonia 1
• Children >40 kg: Use adult dosing 1
• Maximum pediatric dose: 4000 mg per dose 3, 6

Administration Optimization

Extended Infusions for Severe Infections

• Extended infusion (3-4 hours) improves pharmacodynamic target attainment compared to standard 30-minute infusions 3, 2
• Particularly beneficial in critically ill patients with septic shock 2
• Maintains plasma concentrations above MIC for ≥70% of dosing interval, increasing success rates 3

Combination Therapy Considerations

• Administer aminoglycosides separately from piperacillin/tazobactam 2
• Y-connector co-administration may be done under specific conditions only 2
• For severe nosocomial pneumonia: amikacin 15-20 mg/kg IV every 24 hours or gentamicin 5-7 mg/kg IV every 24 hours 2

Common Pitfalls to Avoid

1. Failing to adjust for renal function: Always calculate CrCl before dosing; failure to reduce dose causes nephrotoxicity 1, 5
2. Underdosing nosocomial pneumonia: Must use 4.5 g every 6 hours, not the standard 3.375 g dose 1
3. Inadequate treatment duration: Typically requires 7-14 days depending on infection severity and clinical response 1, 2
4. Mixing with aminoglycosides: Physical incompatibility can inactivate both drugs 2