Piperacillin
- Atc Codes:J01CA12
- CAS Codes:66258-76-2#61477-96-1
- PHARMGKB ID:66258-76-2#61477-96-1
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Drug Interactions
- Genes that may be involved
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Bulgaria: Piperacillin, Pipril; Germany: Piperacillin; Greece: Piperacilline, Pipril; Italy: Ecosette, Farecillin, Picillin, Piperacillina, Piperital, Pipersal, Pipertex, Reparcillin, Semipenil; Luxembourg: Pipcil; Poland: Piperacillin.
North America
Canada: Piperacillin; USA: Piperacillin.
Latin America
Argentina: Piperacilina.
Asia
Japan: Bicphenin, Penmalin, Pentcillin, Piciliant, Piperacillin, Pipeyuncin, Planjin, Taiperacilin.
Drug combinations
Piperacillin and Tazobactam
Chemistry
Piperacillin: C~23~H~27~N~5~O~7~S H~2~O. Mw: 535.57. (1) 4-Thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid, 6-[[[[(4-ethyl-2,3-dioxo-1-piperazinyl)carbonyl]amino]phenylacetyl]amino]-3,3-dimethyl-7-oxo-, monohydrate, [2S-[2α,5α,6β(S*)]]; (2)(2S,5R,6R)-6-[(R)-2-(4-Ethyl-2,3-dioxo-1-piperazinecarboxamido)-2-phenylacetamido]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid monohydrate. CAS-66258-76-2; CAS-61477-96-1 (anhydrous).
Pharmacologic Category
Extended-spectrum Penicillins. (ATC-Code: J01CA12).
Mechanism of action
Inhibits bacterial cell wall synthesis by binding to one or more penicillin-binding proteins, which in turn inhibits final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis.
Therapeutic use
Treatment of susceptible infections such as septicemia, acute and chronic respiratory tract infections, skin and soft tissue infections, and urinary tract infections due to susceptible strains of Pseudomonas, Proteus, and Escherichia coli and Enterobacter. Active against some Streptococci and some anaerobic bacteria. Febrile neutropenia (as part of combination regimen).
Pregnancy and lactiation implications
Adverse events observed in animal studies. Piperacillin crosses placenta and distributes into amniotic fluid. Caution when administering piperacillin to nursing women.
Unlabeled use
Contraindications
Hypersensitivity to piperacillin, other β-lactam antibiotics (penicillins or cephalosporins), or any component of the formulation.
Warnings and precautions
Serious and occasionally severe or fatal hypersensitivity (anaphylactoid) reactions reported in patients on penicillin therapy, especially with history of β-lactam hypersensitivity, history of sensitivity to multiple allergens, or previous IgE-mediated reactions (e.g. anaphylaxis, angioedema, urticaria). Use with caution in asthmatic patients. Bleeding disorders observed (particularly in renal impairment). Leukopenia and neutropenia reported (during prolonged use). Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Increased frequency of fever and rash reported in cystic fibrosis. Use with caution in renal impairment, due to sodium load and adverse effects (anemia, neuropsychological changes); also in history of seizure disorder (high levels, particularly in presence of renal impairment, may increase risk of seizures).