哌拉西林鈉
Piperacillin Sodium
Piperacillin sodium
別名: Pipracil · Pipril · piperacillinum · BL-P 1908 · Cl 867 · CL 227 193 · T 12220 · TA 058
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For bacteremia with or without endocarditis | 30 mg/kg IV q6h for 7-14 days | IV | q6h | 7-14 days | 🌎 NA |
| For respiratory infections | 25-50 mg/kg IV q8h | IV | q8h | — | 🌎 NA |
| For systemic treatment of otitis media or proliferative otitis externa complicated by gram-negative (especially Pseudomonas) bacteria | 20 mg/kg SC three times daily | SC | TID | — | 🌎 NA |
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For bacteremia with or without endocarditis | 30 mg/kg IV q6h for 7-14 days | IV | q6h | 7-14 days | 🌎 NA |
| For respiratory infections | 25-50 mg/kg IV q8h | IV | q8h | — | 🌎 NA |
鳥
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For Bordetella avium infections | 150 mg/kg IM q8-12h | IM | q8-12h | minimum treatment period is two weeks | 🌎 NA |
| For susceptible infections | 100 mg/kg IM two to three times daily | IM | BID-TID | — | 🌎 NA |
| For empirical treatment in Psittacines of gram-negative bacterial infections | 100 mg/kg IM 3-4 times a day if immunocompetent; 4 times a day if immunocompromised | IM | TID-QID | — | 🌎 NA |
爬蟲類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For susceptible infections | 100 mg/kg route not specified q48h | Not specified | q48h | — | 🌎 NA |
| For susceptible infections (Snakes) | 100 mg/kg IM q24h | IM | q24h | — | 🌎 NA |
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For susceptible infections | 15-50 mg/kg IV or IM q6-12h | IV/IM | q6-12h | — | 🌎 NA |
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
哌拉西林是一種廣效性醯胺基青黴素 (acylaminopenicillin) 抗生素，主要用於治療嚴重或具抗藥性的細菌感染。
- 廣效抗菌譜：對許多需氧及厭氧的革蘭氏陽性與陰性菌具有擴展的抗菌範圍，特別是包含許多綠膿桿菌 (Pseudomonas aeruginosa) 及腸桿菌科的菌株。
- 臨床應用：雖然在獸醫學的經驗相對有限，但在等待細菌培養與藥物敏感性試驗結果前，對於重症病患的經驗性療法，或針對混合需氧/厭氧菌及革蘭氏陰性菌污染的手術預防，具有極高的價值。
- 對 β-內醯胺酶的敏感性：與其他氨基青黴素一樣，單獨使用哌拉西林容易被 β-內醯胺酶破壞。因此常與 β-內醯胺酶抑制劑（如他唑巴坦 tazobactam）合併使用以克服抗藥性。
- 給藥方式：口服吸收不佳，必須以腸胃外途徑（靜脈注射、肌肉注射或皮下注射）給藥。
作用機制
Piperacillin is a bactericidal time-dependent antibiotic.
- It binds to specific Penicillin-Binding Proteins (PBPs) (especially PBP-3) located inside the bacterial cell wall.
- Binding to PBPs → inhibition of the third and final stage of bacterial cell wall synthesis (cross-linking of peptidoglycan strands).
- This weakens the cell wall → activation of bacterial autolysins → cell lysis and death.
- Note: Its efficacy is highly dependent on the amount of time the drug concentration remains above the Minimum Inhibitory Concentration (MIC) of the target pathogen.
安全性與警告
禁忌症
- Patients with documented hypersensitivity to beta-lactam antibiotics (penicillins, cephalosporins)
不良反應
- Hypersensitivity reactions (allergic reactions)
- Local tissue irritation, pain at IM injection site
- Thrombophlebitis (with IV administration)
- Antibiotic-associated diarrhea (due to alterations in gut flora)
- Coagulation abnormalities (rare, mostly in renal failure)
- Neurotoxicity/seizures (at very high doses or in renal impairment)
- Clostridium difficile superinfections (rare)
注意事項
High Sodium Content: Because of its sodium content (1.85 mEq per gram), 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) to prevent neurotoxicity or coagulopathies.
- Laboratory Interference: May cause false-positive urine glucose tests (cupric sulfate method) and false-positive direct Coombs' tests. Can falsely decrease aminoglycoside serum concentrations if samples are stored together prior to analysis.
藥物相互作用
Synergistic against certain bacteria in vitro, but penicillins can chemically inactivate aminoglycosides in vivo (especially in renal failure or at massive doses). Do not mix in the same syringe/bag.
Piperacillin may rarely affect platelets; increased monitoring of coagulation parameters is suggested.
Piperacillin may increase methotrexate serum levels.
Reduces renal tubular secretion of piperacillin, maintaining higher systemic levels for longer periods.
Piperacillin may prolong neuromuscular blockade.
監測
- Clinical efficacy (resolution of clinical signs, fever)
- White blood cell count (WBC)
- Renal function (if prolonged use or pre-existing impairment)
- Coagulation parameters (if on concurrent anticoagulants or high doses)
藥物動力學
半衰期
吸收
Not appreciably absorbed from the gut; must be administered parenterally. IM bioavailability is 86% in mares. Peak levels occur in about 30 minutes after IM administration in humans.
分佈
Widely distributed into many tissues and fluids (lung, gallbladder, intestinal mucosa, uterus, bile, interstitial fluid). Low protein binding (19% in mares). Volume of distribution is 0.1 L/kg. CSF penetration is poor with normal meninges (6% of serum) but increases with inflamed meninges (30%). Crosses the placenta and enters milk in low concentrations.
代謝
Metabolized somewhat in the liver to a desethyl metabolite that has minimal antibacterial activity.
排除
Primarily (68%) eliminated unchanged in the urine via active tubular secretion and glomerular filtration; also excreted in the bile.
過量
Single overdoses are unlikely to pose much risk.
- Massive Overdoses: May cause vomiting, diarrhea, or neurotoxicity (seizures).
- Chronic High Doses: Dogs receiving up to 800 mg/kg/day of piperacillin/tazobactam for 6 months demonstrated no serious toxic effects. Doses ≥400 mg/kg/day caused transient liver effects (glycogen granules in cytoplasm, increased smooth endoplasmic reticulum) that mostly reversed after one month.
- Treatment: Supportive care. Monitor renal and neurological status.
可用產品
劑型
- Powder for injection (reconstitution)
人用標示
- Piperacillin Sodium Injection (powder for reconstitution): 2 gram, 3 gram, & 4 gram (as base) vials
- 40 gram bulk vials
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store powder vials at controlled room temperature (20-25°C). Reconstitute with 5 mL diluent per gram. Once reconstituted, use within 4 hours (do not freeze). Further diluted IV bags (50-150 mL) are stable for 24 hours at room temperature and 1 week if refrigerated. No preservatives are used, so sterility is not assured in stored reconstituted products.
飼主須知
- 住院使用：因為此藥物必須透過注射（靜脈、肌肉或皮下）給藥，且需要頻繁投藥，通常會在您的寵物住院期間由醫療人員施打。
- 用途：這是一種強效抗生素，通常保留用於嚴重感染或對一般常見藥物具有抗藥性的細菌感染。
- 副作用：整體而言非常安全。如果您的寵物曾對青黴素或頭孢菌素類抗生素有過敏反應，請務必告知獸醫師。偶爾可能會引起輕微的腸胃不適或腹瀉。
- 注射部位疼痛：如果採用肌肉注射，注射當下可能會產生短暫的疼痛感。
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