피페라실린 나트륨 / 타조박탐 나트륨

광범위 페니실린 + 베타락타마제 억제제Critically Important

**피페라실린/타조박탐(Piperacillin/Tazobactam)**은 베타락타마제 억제제가 결합된 강력한 광범위 항녹농균 페니실린입니다. * **광범위 스펙트럼**: 녹농균을 포함한 많은 그람 양성균, 그람 음성균 및 혐기성 세균에 대해 확장된 항균 범위를 제공합니다. * **임상적 사용**: 주로 심각하고 생명을 위협하는 감염, 배양 결과를 기다리는 동안의 경험적 치료, 또는 혼합 감염이 우려되는 수술적 예방에 사용됩니다. * **수의학적 배경**: 수의학에서의 경험은 제한적이지만, 복강 내 패혈증 및 심각한 균혈증에 대해 매우 안전하고 효과적인 것으로 간주됩니다.

작용 기전: * **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.

동물 종별 용량

Cats

Single-agent therapy of intra-abdominal sepsis · 50 mg/kg · IV or IM · q4-6h · 5-7 days · Dose extrapolated from human dosage with limited studies in dogs or cats.

Birds

Susceptible infections · 100 mg/kg · IM · q8-12h · Reconstitute to 200 mg/mL.
Severe polymicrobic bacteremia · 100 mg/kg · IV · q6h
Preoperative orthopedic or coelomic surgery · 100 mg/kg · IM · q12h

Dogs

Single-agent therapy of intra-abdominal sepsis · 50 mg/kg · IV or IM · q4-6h · 5-7 days · Dose extrapolated from human dosage with limited studies in dogs or cats.
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 · Total dose per dog.
Life-threatening infections (e.g., Pseudomonas) · 80-100 mg/kg · IV · q8h · Human paediatric dose used as a guide; administer by slow IV injection/infusion.
Life-threatening infections · 25-50 mg/kg · IV · q4-6h · Empirical dosing.

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

IVIM

금기

Patients with documented hypersensitive reactions to a beta-lactam or beta-lactamase inhibitor
Known hypersensitivity to penicillins or cephalosporins

이상반응

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)

약물 상호작용

Aminoglycosides (amikacin, gentamicin, tobramycin) · 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.
Anticoagulants (heparin, warfarin) · Piperacillin may rarely affect platelets; increased monitoring of coagulation parameters is suggested.
Methotrexate · Piperacillin may increase MTX serum levels.
Probenecid · Can reduce the renal tubular secretion of both piperacillin and tazobactam, maintaining higher systemic levels for a longer period.
Vecuronium · Piperacillin may prolong neuromuscular blockade.
Non-depolarizing muscle relaxants · Piperacillin enhances the effects of non-depolarizing muscle relaxants. · moderate
Gentamicin · Inactivates piperacillin if mixed in the same syringe. · major
Aminoglycosides · Synergistic bactericidal effect against pseudomonal septicaemias when administered systemically (not mixed in vitro). · minor

모니터링

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

과용량

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.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.