ピペラシリンナトリウム・タゾバクタムナトリウム
Piperacillin Sodium + Tazobactam
Piperacillin sodium/tazobactam sodium
別名: Zosyn · Tazocin · CL 298741 · YTR 830H · piperacillinum · BL-P 1908 · Cl 867 · CL 227193 · T 12220 · TA 058 · Pip-Tazo · Piperacillin sodium · Tazobactam sodium
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Single-agent therapy of intra-abdominal sepsis | 50 mg/kg | IV or IM | q4-6h | 5-7 days | 🌎 NA |
| Bacterial sepsis | 3.375 grams (total dose per dog) IV q6h or 4.5 grams (total dose per dog) IV q8h | IV | q6h or q8h | 7 days | 🌎 NA |
| Life-threatening infections (e.g., Pseudomonas) | 80-100 mg/kg | IV | q8h | — | 🌍 EU |
| Life-threatening infections | 25-50 mg/kg | IV | q4-6h | — | 🌍 EU |
- Single-agent therapy of intra-abdominal sepsis: Dose extrapolated from human dosage with limited studies in dogs or cats.
- Bacterial sepsis: Total dose per dog.
- Life-threatening infections (e.g., Pseudomonas): Human paediatric dose used as a guide; administer by slow IV injection/infusion.
- Life-threatening infections: Empirical dosing.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Single-agent therapy of intra-abdominal sepsis | 50 mg/kg | IV or IM | q4-6h | 5-7 days | 🌎 NA |
- Single-agent therapy of intra-abdominal sepsis: Dose extrapolated from human dosage with limited studies in dogs or cats.
鳥
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Susceptible infections | 100 mg/kg | IM | q8-12h | — | 🌎 NA |
| Severe polymicrobic bacteremia | 100 mg/kg | IV | q6h | — | 🌎 NA |
| Preoperative orthopedic or coelomic surgery | 100 mg/kg | IM | q12h | — | 🌎 NA |
- Susceptible infections: Reconstitute to 200 mg/mL.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
ピペラシリン/タゾバクタムは、β-ラクタマーゼ阻害剤を配合した強力な広域スペクトル抗緑膿菌ペニシリンです。
- 広域スペクトル: 緑膿菌を含む多くのグラム陽性菌、グラム陰性菌、嫌気性菌に対して拡張された抗菌スペクトルを提供します。
- 臨床用途: 重篤で生命を脅かす感染症、培養結果が出るまでの経験的治療、または混合感染が懸念される外科的予防にしばしば予約されます。
- 獣医療での背景: 獣医療での経験は限られていますが、腹腔内敗血症や重度の菌血症に対して非常に安全で効果的であると考えられています。
作用機序
- Piperacillin is a bactericidal beta-lactam antibiotic. It binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall → inhibits the third and last stage of bacterial cell wall synthesis → cell lysis and death.
- Tazobactam is a "suicide" inhibitor. It irreversibly binds to beta-lactamases (Richmond-Sykes types II-V) → prevents these enzymes from hydrolyzing the beta-lactam ring of piperacillin.
- Synergy: Tazobactam itself has minimal antibacterial activity, but its combination with piperacillin restores and expands piperacillin's efficacy against beta-lactamase-producing organisms.
安全性・警告
禁忌
- Patients with documented hypersensitive reactions to a beta-lactam or beta-lactamase inhibitor
- Known hypersensitivity to penicillins or cephalosporins
有害事象
- Hypersensitivity reactions
- Local effects (thrombophlebitis) associated with IV injection
- Antibiotic-associated diarrhea (alterations in gut flora)
- Coagulation abnormalities (rare, particularly in renal failure)
- Neurotoxicity/seizures (at very high doses, especially with diminished renal function)
- Clostridium difficile superinfections (rare)
- Nausea
- Diarrhoea
- Skin rashes
- Pain on intramuscular injection
- Sodium overload (in susceptible patients)
注意事項
High Sodium Content: High dosages may adversely affect patients with cardiac failure or hypernatremic conditions.
- Renal Impairment: Dosage adjustment may be required in patients with significantly decreased renal function (CrCl <40 mL/min).
- Laboratory Interference: May cause false-positive results for urine glucose (cupric sulfate methods like Clinitest), direct antiglobulin (Coombs') tests, and urine protein (sulfosalicylic acid, boiling, nitric acid, or acetic acid tests). May also falsely decrease aminoglycoside serum quantitative analysis if samples are stored prior to analysis.
医薬品相互作用
Synergistic or additive activity against certain bacteria. However, penicillins can inactivate aminoglycosides in vitro and in vivo in patients in renal failure or at massive dosages. Amikacin is the most resistant to this inactivation.
Piperacillin may rarely affect platelets; increased monitoring of coagulation parameters is suggested.
Piperacillin may increase MTX serum levels.
Can reduce the renal tubular secretion of both piperacillin and tazobactam, maintaining higher systemic levels for a longer period.
Piperacillin may prolong neuromuscular blockade.
Piperacillin enhances the effects of non-depolarizing muscle relaxants.
Inactivates piperacillin if mixed in the same syringe.
Synergistic bactericidal effect against pseudomonal septicaemias when administered systemically (not mixed in vitro).
監視
- Efficacy for the infection treated (CBC, clinical signs, etc.)
- Coagulation parameters (if patient is concurrently on anticoagulants)
- Clinical efficacy
- Culture and sensitivity results
- Renal function
- Electrolytes (specifically sodium) in patients with cardiac or renal impairment
薬物動態
吸収
Time-dependent antibiotic. Must be administered parenterally.
分布
Piperacillin is distributed in milk in low concentrations. It is not known if tazobactam enters milk.
代謝
Piperacillin inhibits the excretion of the tazobactam component in the dog.
消失
In dogs, piperacillin reduced the renal clearance of tazobactam, presumably due to competition for tubular secretion.
過剰投与
Single overdoses are unlikely to pose much risk, although very large overdoses may cause vomiting, diarrhea, or neurotoxicity.
- Toxicity Studies: Dogs receiving up to 800 mg/kg/day of piperacillin/tazobactam for 6 months demonstrated no serious toxic effects. Doses at 400 mg/kg/day or greater caused some transient effects to the liver (glycogen granules in the cytoplasm and increases in smooth endoplasmic reticulum in hepatocytes) that were mostly reversed after one month.
- Treatment: Treatment for overdoses, if required, is supportive.
製品
製剤
- Injection (powder for solution)
- Premixed frozen containers
- 2.25 g powder for injection (2 g piperacillin sodium + 0.25 g tazobactam)
- 4.5 g powder for injection (4 g piperacillin sodium + 0.5 g tazobactam)
ヒト用医薬品
- Piperacillin Sodium & Tazobactam Injection (powder for solution); Zosyn®: 2.25 g, 3.375 g, 4.5 g, and 40.5 g vials (preservative free)
- Premixed frozen Galaxy containers: 3.375 g/50 mL and 4.5 g/100 mL
- Tazocin 2.25 g powder for injection
- Tazocin 4.5 g powder for injection
規制ステータス
Human authorized product used off-label under the cascade. Reserved for life-threatening infections.
Human authorized product used off-label under the cascade. Reserved for life-threatening infections.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store injection vials at controlled room temperature (20-25°C). Reconstitute conventional vials with 5 mL of diluent per gram of piperacillin. Once reconstituted, use immediately. Discard after 24 hours if kept at room temperature or 48 hours if refrigerated. Do not freeze reconstituted vials. IV bags (50-150 mL) containing further diluted product are stable for up to 24 hours at room temperature and one week if refrigerated.
飼主向け情報
注意: この薬は通常、重度の感染症で入院しているペットに予約されています。
- 投与方法: 獣医師により静脈内（IV）または筋肉内（IM）注射として投与されます。
- 安全性: 一般的に非常に安全ですが、ペットがペニシリンや他の抗生物質に対してアレルギー反応を起こしたことがある場合は獣医師にお知らせください。
- 副作用: 軽度の胃腸の不調や下痢を引き起こす可能性があります。重篤な副作用はまれですが、極端に高用量の場合は神経症状が含まれることがあります。
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