From the Research
Zosyn (piperacillin-tazobactam) is a suitable antibiotic choice for treating pyelonephritis, especially in cases involving extended-spectrum β-lactamase (ESBL)-producing organisms, as it may be a reasonable alternative to carbapenems and can help mitigate the risk of emergence of carbapenem-resistant organisms. The typical dosage is 3.375g IV every 6 hours or 4.5g IV every 8 hours for 7-14 days, with dose adjustments needed for patients with renal impairment 1. Zosyn is particularly useful for cases involving suspected or confirmed resistant organisms, healthcare-associated infections, or when patients have recently been on antibiotics. It works by combining piperacillin, a penicillin antibiotic that disrupts bacterial cell wall synthesis, with tazobactam, a beta-lactamase inhibitor that prevents bacterial enzymes from inactivating the piperacillin.
Some key points to consider when using Zosyn for pyelonephritis include:
- The efficacy of Zosyn in treating ESBL-producing pyelonephritis has been demonstrated in studies, showing no significant difference in clinical outcomes compared to carbapenems 1, 2.
- Zosyn may be a useful option for reducing the risk of carbapenem-resistant organism emergence, as it has been shown to have a lower incidence of carbapenem-resistant organism isolation compared to carbapenem therapy 1.
- Treatment should be guided by urine culture results, and patients should be monitored for clinical improvement within 48-72 hours.
- Adequate hydration and fever control are important supportive measures during treatment.
- Other treatment options, such as fosfomycin, may also be effective for treating complicated urinary tract infections, including pyelonephritis, and offer a differentiated mechanism of action 3.
Overall, Zosyn is a viable treatment option for pyelonephritis, particularly in cases involving ESBL-producing organisms, and its use may help reduce the risk of carbapenem-resistant organism emergence.