Piperacillin

Piperacillin.svg

Piperacillin is a broad-spectrum beta-lactam antibiotic of the ureidopenicillin class. It is commonly used in combination with a beta-lactamase inhibitor such as tazobactam to enhance its effectiveness against beta-lactamase-producing bacteria.

Mechanism of Action

Piperacillin works by inhibiting the synthesis of bacterial cell walls. It binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, which inhibits the final transpeptidation step of peptidoglycan synthesis. This action leads to the weakening of the cell wall and ultimately causes cell lysis and death of the bacterium.

Spectrum of Activity

Piperacillin has a broad spectrum of activity against both Gram-positive and Gram-negative organisms. It is particularly effective against Pseudomonas aeruginosa, a common pathogen in hospital-acquired infections.

Clinical Uses

Piperacillin is used to treat a variety of infections, including:

• Pneumonia
• Sepsis
• Urinary tract infections
• Intra-abdominal infections
• Skin and soft tissue infections

Combination with Tazobactam

Piperacillin is often combined with tazobactam, a beta-lactamase inhibitor, to form piperacillin/tazobactam. This combination extends the antibiotic's spectrum of activity by protecting piperacillin from degradation by beta-lactamase enzymes produced by resistant bacteria.

Pharmacokinetics

Piperacillin is administered intravenously. It is widely distributed in body tissues and fluids, including the lungs, liver, kidneys, bone, and bile. The drug is primarily excreted unchanged in the urine.

Side Effects

Common side effects of piperacillin include:

• Allergic reactions
• Gastrointestinal disturbances
• Thrombocytopenia
• Neutropenia
• Electrolyte imbalances

Contraindications

Piperacillin should not be used in patients with a known allergy to penicillins or other beta-lactam antibiotics. Caution is advised in patients with renal impairment due to the risk of accumulation and toxicity.

History

Piperacillin was developed in the 1970s and has since become a valuable antibiotic in the treatment of serious infections, particularly those caused by resistant organisms.

See Also

• Penicillin
• Beta-lactam antibiotic
• Antibiotic resistance
• Pseudomonas aeruginosa

Penicillin antibiotics

• penicillins first generation (natural penicillins)
  • benzathine penicillin, procaine penicillin, penicillin g, penicillin v, penicillin vk

• penicillins second generation (penicillinase-resistant penicillins)
  • cloxacillin, dicloxacillin, flucloxacillin, methicillin, nafcillin, oxacillin

• penicillins third generation (aminopenicillins)
  • amoxicillin, ampicillin, ampicillin-sulbactam, bacampicillin, pivampicillin
• see also amoxicillin-clavulanate

• penicillins fourth generation (extended-spectrum penicillins)
  • carbenicillin, mezlocillin, piperacillin, piperacillin-tazobactam, ticarcillin, ticarcillin-clavulanate

• Dailymed label info on Piperacillin
• FDA Piperacillin

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