From the Guidelines
Zosyn (piperacillin-tazobactam) is not the first-line treatment for uncomplicated urinary tract infections (UTIs), but it can be effective in treating complicated or severe cases, particularly those caused by multidrug-resistant organisms. According to the most recent and highest quality study 1, Zosyn can be used to treat complicated UTIs, including those caused by carbapenem-resistant Pseudomonas aeruginosa (CRPA) and difficult-to-treat P. aeruginosa (DTR-PA). The recommended treatment duration for complicated UTIs is 5-10 days, and the typical adult dosage for UTIs is 3.375g or 4.5g administered intravenously every 6-8 hours.
Some key points to consider when using Zosyn to treat UTIs include:
- Zosyn is a broad-spectrum antibiotic combination that works against many bacteria that cause UTIs, including resistant strains.
- It is generally reserved for more serious infections or when other antibiotics have failed, as it requires intravenous administration in a healthcare setting.
- Common side effects include diarrhea, headache, and nausea.
- Patients should complete the full course of treatment even if symptoms improve before completion to ensure the infection is fully eliminated and to prevent antibiotic resistance.
It's also important to note that other antibiotics, such as nitrofurantoin, trimethoprim-sulfamethoxazole, and fosfomycin, are recommended as first-line treatments for uncomplicated UTIs, as stated in the study 1. However, for complicated or severe cases, Zosyn may be a suitable option, as supported by the study 1. Additionally, the study 1 suggests that short-duration courses of antibiotics, including Zosyn, can be effective in treating complicated UTIs, with similar clinical success rates to long-duration therapy.
From the FDA Drug Label
Aerobic bacteria Gram-negative bacteria Escherichia coli
Anaerobic bacteria Bacteroides fragilis group (B. fragilis, B. ovatus, B. thetaiotaomicron, and B. vulgatus)
Zosyn (piperacillin/tazobactam) is effective against certain bacteria that cause urinary tract infections (UTIs), including:
- Escherichia coli (E. coli)
- Bacteroides fragilis group However, the label does not explicitly state that Zosyn is indicated for the treatment of UTIs. 2
From the Research
Treatment of UTIs
- Zosyn, also known as piperacillin-tazobactam, is a treatment option for urinary tract infections (UTIs) caused by certain bacteria, including ESBL-producing Enterobacteriaceae 3, 4.
- The efficacy of piperacillin-tazobactam for treating UTIs has been studied, with one study finding that it may be an effective alternative to carbapenems for nonbacteremic UTIs due to ESBL-producing Enterobacteriaceae 4.
- Piperacillin-tazobactam has been shown to be effective in eradicating pathogens and improving clinical outcomes in patients with complicated UTIs 3.
Comparison to Other Treatments
- Piperacillin-tazobactam has been compared to carbapenems for the treatment of UTIs, with one study finding no difference in clinical response between the two treatments 4.
- Aminoglycosides have also been studied as a treatment option for UTIs, with one study finding that they are non-inferior to carbapenems and piperacillin-tazobactam for 30-day mortality 5.