From the Guidelines
Zosyn is a penicillin-containing medication, specifically a combination of piperacillin, an extended-spectrum penicillin antibiotic, and tazobactam, a beta-lactamase inhibitor, as evident from the most recent and highest quality study 1.
Key Points to Consider
- The combination of piperacillin and tazobactam in Zosyn allows it to work against bacteria that would normally be resistant to penicillins alone, as seen in the treatment guidelines for various infections 1.
- Patients with penicillin allergies should avoid Zosyn or use it with extreme caution due to the risk of cross-reactivity, and healthcare providers should be informed about any history of penicillin allergy before prescribing Zosyn.
- The severity of previous penicillin reactions should be considered before administration, and alternative non-beta-lactam antibiotics may need to be selected for patients with severe penicillin allergies.
Clinical Implications
- Zosyn's penicillin component is crucial in treating infections caused by bacteria that are susceptible to extended-spectrum penicillins, such as certain strains of Streptococcus and Staphylococcus, as outlined in the guidelines for skin and soft tissue infections 1.
- The use of Zosyn should be guided by local antimicrobial resistance patterns and patient-specific factors, including allergy history and renal function, to minimize the risk of adverse effects and optimize treatment outcomes, as emphasized in the guidelines for hospital-acquired and ventilator-associated pneumonia 1.
Recommendations for Practice
- Healthcare providers should carefully evaluate the risk-benefit ratio of using Zosyn in patients with penicillin allergies and consider alternative treatment options when necessary.
- Patients should be closely monitored for signs of allergic reactions or other adverse effects when receiving Zosyn, and dosage adjustments should be made as needed to minimize the risk of toxicity.
From the FDA Drug Label
Piperacillin sodium is derived from D(-)-α-aminobenzyl-penicillin Piperacillin and tazobactam for injection is a combination of piperacillin, a penicillin-class antibacterial and tazobactam, a beta-lactamase inhibitor Zosyn is another name for piperacillin/tazobactam.
- The active ingredient piperacillin is a penicillin-class antibacterial.
- Therefore, Zosyn is a penicillin 2.
From the Research
Zosyn Classification
- Zosyn, also known as piperacillin/tazobactam, is a beta-lactam/beta-lactamase inhibitor combination with a broad spectrum of antibacterial activity 3, 4, 5.
- This combination is classified as a type of penicillin, as piperacillin is a ureidopenicillin, which is a subclass of penicillins 5.
- The addition of tazobactam, a beta-lactamase inhibitor, enhances the activity of piperacillin against beta-lactamase-producing bacteria, making it effective against a wide range of Gram-positive and Gram-negative aerobic and anaerobic bacteria 3, 4, 5.
Mechanism of Action
- Piperacillin/tazobactam works by inhibiting the synthesis of the bacterial cell wall, ultimately leading to the death of the bacterial cell 3, 4, 5.
- Tazobactam protects piperacillin from degradation by beta-lactamases, allowing piperacillin to exert its antibacterial effects 5.
Clinical Use
- Piperacillin/tazobactam is used to treat a variety of infections, including intra-abdominal, skin and soft tissue, lower respiratory tract, and urinary tract infections, as well as febrile neutropenia 3, 4.
- It is often used in combination with an aminoglycoside for the empirical treatment of severe infections 3, 5.