GENERIC NAME: piperacillin and tazobactam
BRAND NAME: Zosyn
DRUG CLASS AND MECHANISM: Zosyn is an injectable combination of two antibiotics, piperacillin and tazobactam, with broad spectrum activity against an extended range of bacterial species. Piperacillin is an extended-spectrum penicillin antibiotic, but it can be destroyed by an enzyme produced by bacteria called beta lactamase. Tazobactam inhibits beta lactamase and prevents the destruction of piperacillin. Therefore, tazobactam is given with piperacillin to enhance the activity of piperacillin in eradicating bacterial infections.
Piperacillin kills bacteria by inhibiting the synthesis of bacterial cell walls. It binds preferentially to specific penicillin-binding proteins (PBPs) located inside bacterial cell walls. PBPs vary among bacterial species, and thus susceptibility to piperacillin depends on the ability of piperacillin to bind to each species' specific PBPs.
Susceptible bacteria include:
- Aerobic and facultative gram-positive microorganisms: Staphylococcus aureus
- Aerobic and facultative gram-negative microorganisms: Acinetobacter baumannii, Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, and Pseudomonas aeruginosa
- Gram-negative anaerobes: Bacteroides fragilis group (B.fragilis, B. ovatus, B. thetaiotaomicron, and B. vulgatus)
- Piperacillin and tazobactam was approved by the US Food and Drug Administration (FDA) in October 1993.
PRESCRIBED FOR: Piperacillin and tazobactam is used for the treatment of moderate to severe infections caused by piperacillin-resistant, piperacillin/tazobactam susceptible, β-lactamase producing strains of bacteria implicated in the following specified conditions:
- Community-acquired pneumonia (moderate severity only): caused by piperacillin-resistant, β-lactamase producing strains of Haemophilus influenzae.
- Intra-abdominal infections: For the treatment of appendicitis complicated by rupture or abscess and peritonitis caused by piperacillin-resistant, β-lactamase producing strains of Staphylococcus aureus.
- Pelvic infection: For the treatment of postpartum endometriosis or pelvic inflammatory disease caused by piperacillin-resistant, β-lactamase producing strains of Escherichia coli.
- Nosocomial (hospital acquired) pneumonia: For the treatment of moderate to severe hospital acquired pneumonia caused by piperacillin-resistant, β-lactamase producing strains of Staphylococcus aureus and by piperacillin/tazobactam-susceptible Acinetobacter baumannii, Haemophilus influenzae, Klebsiella pneumonia, and Pseudomonas aeruginosa (nosocomial pneumonia caused by P. aeruginosa should be treated in combination with an aminoglycoside).
- Skin and skin structure infections: For the treatment of skin and skin structure infections including cellulitis, cutaneous abscesses, and ischemic/diabetic foot infections caused by piperacillin-resistant, β-lactamase producing strains of Staphylococcus aureus.
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