哌拉西林鈉/他唑巴坦鈉
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
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
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
哌拉西林/他唑巴坦 (Piperacillin/Tazobactam) 是一種強效的廣效性抗綠膿桿菌青黴素，並結合了β-內醯胺酶抑制劑。
- 廣效性：對許多革蘭氏陽性菌、革蘭氏陰性菌及厭氧菌（包括綠膿桿菌）具有擴展的抗菌範圍。
- 臨床應用：通常保留用於嚴重、危及生命的感染、等待培養結果前的經驗性療法，或涉及混合需氧/厭氧感染的外科預防。
- 獸醫應用：雖然在獸醫學中的經驗有限，但對於腹腔內敗血症和嚴重菌血症被認為是相當安全且高度有效的。
作用機轉
- 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.
安全性與警告
禁忌症
- Patients with documented hypersensitive reactions to a beta-lactam or beta-lactamase inhibitor
- Known hypersensitivity to penicillins or cephalosporins
不良反應
- 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.
藥物交互作用
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).
監測
- 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
藥物動力學
吸收
Time-dependent antibiotic. Must be administered parenterally.
分佈
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.
排除
In dogs, piperacillin reduced the renal clearance of tazobactam, presumably due to competition for tubular secretion.
過量
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.
可用產品
劑型
- 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)
人用標示
- 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
各地核准狀態
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.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
注意： 此藥物通常保留給患有嚴重感染的住院寵物使用。
- 給藥方式：由您的獸醫師以靜脈 (IV) 或肌肉 (IM) 注射方式給予。
- 安全性：通常非常安全，但如果您的寵物曾對青黴素或其他抗生素有過敏反應，請告知您的獸醫師。
- 副作用：可能引起輕微的腸胃不適或腹瀉。嚴重的副作用很罕見，但在極高劑量下可能包括神經系統症狀。
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