Piperacillin/Tazobactam Pharmacology

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

Education, Health & Fitness, Medicine

5 • 716 Ratings

🗓️ 25 September 2025

⏱️ 13 minutes

🔗️ Recording | iTunes | RSS

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Summary

Zosyn (piperacillin/tazobactam) is a broad-spectrum β-lactam/β-lactamase inhibitor combination used widely in hospitals. Piperacillin covers gram-positive, gram-negative, and anaerobic bacteria, while tazobactam helps protect against β-lactamase breakdown. It is commonly used for pneumonia, intra-abdominal infections, skin and soft tissue infections, and febrile neutropenia. An important pharmacology pearl for exams is understanding that Pseudomonas, but it doesn't cover MRSA.

The drug is renally eliminated, so dosing adjustments are needed in kidney impairment. Many institutions use extended or prolonged infusions to maximize time above the MIC, which can improve efficacy. Standard dosing is 3.375 g to 4.5 g every 6–8 hours, with modifications for dialysis patients.

Adverse effects include hypersensitivity, gastrointestinal upset, electrolyte imbalances like hypokalemia, and blood count changes with prolonged therapy. A key clinical concern is nephrotoxicity risk, especially when used with vancomycin. Monitoring renal function and electrolytes are important.

Methotrexate and probenecid are two medications that can interact with Zosyn. Concentrations of Zosyn can be increased when these medications are used in combination.

Transcript

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0:00.0	Hey, all, welcome back to the Real Life Pharmacology podcast. I'm your host, pharmacist, Eric Christensen.
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0:31.3	All right.
0:32.1	The drug of the day today is pipacillin tasabactam.
0:37.3	That is a combination of two medications.
0:40.2	Brand name you most commonly here is zosen associated with this medication.
0:46.5	This is an IV-only medication.
0:49.6	So it's obviously primarily going to be used in an inpatient infusion type of setting in most
0:57.2	situations with some occasional exceptions to that, of course.
1:03.0	So again, we've got kind of a combination medication here.
1:07.0	And as you could probably tell by the ending in pipacillin, this is a penicillin type antibiotic.
1:14.3	It is what's considered an extended spectrum, and basically all that means is it covers a bunch of different bacteria.
1:23.2	You may also hear it termed as a broad spectrum antibiotic as well.
1:29.9	So mechanistically,
1:32.9	Pipericillin inhibits bacterial cell wall synthesis
1:36.3	by binding to penicillin binding proteins.
1:40.5	Now, the other component of this medication, Tasebactam,
1:46.1	this irreversibly inhibits many beta lactamases,
	...

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