What is the maximum dose of piperacillin (antibiotic) with tazobactam (beta-lactamase inhibitor) for an 8-month-old baby with pneumonia?

Maximum Dose of Piperacillin-Tazobactam for an 8-Month-Old with Pneumonia

For an 8-month-old infant with pneumonia, the maximum dose of piperacillin-tazobactam is 90 mg/kg (80 mg piperacillin/10 mg tazobactam component) every 6 hours, administered intravenously over 30 minutes. 1

FDA-Approved Dosing for Infants

The FDA label provides clear age-based dosing for pediatric patients with nosocomial pneumonia 1:

• For infants 2 months to 9 months of age: 90 mg/kg (80 mg piperacillin/10 mg tazobactam) every 6 hours 1
• For children older than 9 months: 112.5 mg/kg (100 mg piperacillin/12.5 mg tazobactam) every 6 hours 1
• All doses should be infused over 30 minutes 1

Dosing Algorithm Based on Age and Indication

Since your patient is 8 months old, they fall into the younger age category and should receive:

• 90 mg/kg every 6 hours (not the higher 112.5 mg/kg dose used for older children) 1
• This translates to 80 mg/kg of piperacillin component and 10 mg/kg of tazobactam component 1
• Frequency: Every 6 hours (4 times daily) for pneumonia 1

Important Clinical Considerations

Extended infusion strategies have been studied in pediatric populations and may improve pharmacodynamic target attainment 2, 3:

• Research suggests that extended infusions (4 hours) at doses of 80-100 mg/kg every 6-8 hours achieve adequate drug exposure in critically ill children 3
• However, the FDA-approved standard remains 30-minute infusions 1
• Extended infusions may be considered in consultation with infectious disease specialists for resistant organisms 2

Renal function monitoring is critical, as piperacillin-tazobactam clearance is significantly affected by kidney function 4:

• Infants have prolonged drug half-lives compared to older children and adults 4
• Dose adjustments are required if creatinine clearance is impaired 1

Common Pitfalls to Avoid

• Do not use the 112.5 mg/kg dose in infants under 9 months of age—this exceeds FDA-approved dosing for this age group 1
• Do not extend the dosing interval to every 8 hours for pneumonia in this age group—the FDA specifies every 6 hours for nosocomial pneumonia 1
• Ensure proper infusion time: The standard 30-minute infusion should not be given as a bolus 1
• Separate administration from aminoglycosides: If combination therapy is needed, reconstitute and administer separately, though Y-site co-administration is possible under specific conditions 1

Expected Clinical Response

• Clinical improvement should be evident within 48-72 hours of initiating appropriate therapy 5, 6
• If no improvement occurs within this timeframe, consider alternative diagnoses, resistant organisms, or inadequate source control 6