피페라실린 나트륨 / 타조박탐 나트륨
Piperacillin Sodium + Tazobactam
Piperacillin sodium/tazobactam sodium
다른 이름: 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 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
새
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
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.
안전성·주의사항
금기사항
- Patients with documented hypersensitive reactions to a beta-lactam or beta-lactamase inhibitor
- Known hypersensitivity to penicillins or cephalosporins
부작용
- 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)
주의
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.
약물 상호작용
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).
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
약동학
흡수
Time-dependent antibiotic. Must be administered parenterally.
분포
Piperacillin is distributed in milk in low concentrations. It is not known if tazobactam enters milk.
대사
Piperacillin inhibits the excretion of the tazobactam component in the dog.
배설
In dogs, piperacillin reduced the renal clearance of tazobactam, presumably due to competition for tubular secretion.
과다투여
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.
제품
제형
- 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)
인용의약품
- 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
규제 현황
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.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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.
보호자 정보
참고: 이 약물은 일반적으로 심각한 감염으로 입원한 반려동물을 위해 예약되어 있습니다.
- 투여 방법: 수의사가 정맥(IV) 또는 근육(IM) 주사로 투여합니다.
- 안전성: 일반적으로 매우 안전하지만, 반려동물이 페니실린이나 다른 항생제에 알레르기 반응을 보인 적이 있다면 수의사에게 알려주세요.
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