From the FDA Drug Label
Clostridioides difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including piperacillin and tazobactam for injection, and may range in severity from mild diarrhea to fatal colitis. Pseudomembranous colitis (≤1%)
Piperacillin-Tazobactam can cause pseudomembranous colitis, as it has been reported in patients receiving the drug, although the exact frequency is not well established. Key points to consider:
- CDAD has been reported with the use of nearly all antibacterial agents, including Piperacillin-Tazobactam.
- Pseudomembranous colitis is a type of CDAD that can range in severity from mild diarrhea to fatal colitis.
- The drug label reports pseudomembranous colitis as an adverse reaction, although the frequency is less than or equal to 1% 1 1.
From the Research
Pseudomembranous Colitis and Piperacillin-Tazobactam
- Pseudomembranous colitis, also known as Clostridium difficile-associated diarrhea (CDAD), is a potential adverse effect of broad-spectrum antibiotics 2.
- The use of broad-spectrum antibiotics, including piperacillin-tazobactam, can disrupt the normal intestinal flora, leading to the proliferation of Clostridium difficile and the development of pseudomembranous colitis 3, 4.
- Piperacillin-tazobactam has been implicated as a potential cause of pseudomembranous colitis, although the evidence is not direct 4.
- A study found that antibiotics, including piperacillin, can induce pseudomembranous colitis, and that discontinuation of the culprit antibiotic and treatment with narrow-spectrum antibiotics like metronidazole and vancomycin can lead to recovery 4.
Treatment and Management
- The management of antibiotic-associated pseudomembranous colitis involves discontinuation of the offending antibiotic, replacement of fluid and electrolytes, and treatment with anticlostridial antibiotics like metronidazole and vancomycin 3, 4.
- Piperacillin-tazobactam has been used to treat Pseudomonas aeruginosa bacteraemia in a patient with polymicrobial bacteraemia, including Clostridioides difficile 5.
- The use of piperacillin-tazobactam in patients with pseudomembranous colitis may be necessary in certain cases, such as when treating a concurrent infection, but its potential to exacerbate the condition should be considered 5.