From the Guidelines
Yes, Zosyn (piperacillin-tazobactam) effectively covers Escherichia coli (E. coli) infections. This broad-spectrum antibiotic combination consists of piperacillin, an extended-spectrum penicillin, and tazobactam, a beta-lactamase inhibitor that prevents bacterial enzymes from inactivating piperacillin. Zosyn is typically dosed at 3.375g or 4.5g IV every 6-8 hours for adults with normal renal function, with dose adjustments needed for patients with impaired kidney function. It demonstrates excellent activity against most E. coli strains, including many that produce extended-spectrum beta-lactamases (ESBLs), though some highly resistant strains may not be susceptible. Zosyn works by inhibiting bacterial cell wall synthesis, causing cell death. It's commonly used for complicated intra-abdominal infections, urinary tract infections, pneumonia, and skin/soft tissue infections where E. coli is a suspected pathogen. However, local antibiotic resistance patterns should be considered, and susceptibility testing is recommended to confirm effectiveness against specific isolates. According to the most recent study 1, piperacillin-tazobactam is recommended for high-risk or severely ill adults with intra-abdominal infections, which may include E. coli. Additionally, the study 1 provides moderate-certainty evidence for the use of piperacillin-tazobactam in the treatment of complicated urinary tract infections (cUTI) caused by E. coli, including those with extended-spectrum beta-lactamase (ESBL) production.
Some key points to consider when using Zosyn to treat E. coli infections include:
- Local antibiotic resistance patterns should be taken into account when selecting empiric therapy 1
- Susceptibility testing is recommended to confirm the effectiveness of Zosyn against specific E. coli isolates 1
- Zosyn is typically used in combination with other antibiotics to ensure broad-spectrum coverage 1
- The dose and duration of Zosyn therapy may need to be adjusted based on the severity of the infection and the patient's renal function 1
Overall, Zosyn is a effective option for treating E. coli infections, but its use should be guided by local resistance patterns and susceptibility testing to ensure optimal outcomes.
From the FDA Drug Label
Piperacillin and tazobactam for injection, USP is indicated in adults and pediatric patients (2 months of age and older) for the treatment of appendicitis (complicated by rupture or abscess) and peritonitis caused by beta-lactamase producing isolates of Escherichia coli Piperacillin and tazobactam for injection, USP is indicated in adults for the treatment of postpartum endometritis or pelvic inflammatory disease caused by beta-lactamase producing isolates of Escherichia coli.
Yes, Zosyn (piperacillin/tazobactam) covers E. coli, specifically beta-lactamase producing isolates of Escherichia coli, for the treatment of certain infections, including intra-abdominal infections and female pelvic infections 2 2.
From the Research
Zosyn Coverage for E. coli
- Zosyn, also known as piperacillin-tazobactam, is a broad-spectrum antibiotic used to treat various bacterial infections, including those caused by E. coli 3.
- Studies have shown that piperacillin-tazobactam can be effective against E. coli, including strains that produce extended-spectrum β-lactamases (ESBLs) 4, 5.
- However, the effectiveness of piperacillin-tazobactam against E. coli can depend on various factors, such as the specific strain of the bacteria, the severity of the infection, and the presence of other underlying health conditions 6.
- In areas with low frequency of OXA-1 co-production, piperacillin-tazobactam may be a treatment option for non-severe cases of ESBL-producing E. coli bacteremia 5.
- Piperacillin-tazobactam has been shown to be effective in treating various types of infections, including urinary tract infections, intra-abdominal infections, and skin/soft tissue infections, which can be caused by E. coli 3, 7.
Key Findings
- A randomized clinical trial found that piperacillin-tazobactam was not noninferior to meropenem in treating bloodstream infections caused by E. coli or Klebsiella pneumoniae with ceftriaxone resistance 4.
- A preliminary analysis found that piperacillin-tazobactam may be a treatment option for non-severe cases of ESBL-producing E. coli bacteremia in areas with low frequency of OXA-1 co-production 5.
- A systematic review protocol aims to assess the benefits and harms of empirical and definitive piperacillin-tazobactam versus carbapenems for patients with severe bacterial infections, including those caused by E. coli 6.
- An updated review of piperacillin-tazobactam found that it is an effective treatment for various bacterial infections, including those caused by E. coli, and has a broad spectrum of antibacterial activity 3.
- A retrospective cohort study found that extended-infusion piperacillin-tazobactam did not significantly improve clinical outcomes compared to standard-infusion piperacillin-tazobactam for sepsis syndromes, including those caused by E. coli 7.