Infectious Disease Compendium

Piperacillin (Pipracil®)

Dosing

CrCl Formula

CrCl > 80: 4-5 gm iv q 8 h.

CrCl 80-50: 4-5 gm iv q 8 h.

CrCl 50-10: 4-5 gm iv q 12 h.

CrCl < 10: 4-5 gm iv q 24 h.

Hemodialysis:

Peritoneal dialysis:

Important side effects

Important drug interactions

Methotrexate, probenecid, vecuronium.

Rants and Screeds

Pearls

For Pseudomonas, Piperacillin alone is BETTER than Piperacillin/Tazobactam. Since Pseudomonas does not make a beta lactamase that is inhibited by tazobactam, the tazobactam instead acts as a competitive inhibitor to the Piperacillin, raising the MIC 2-4 times.

Treatment of choice

Use for

It is the best anti pseudomonas penicillin we got. Yes, got. abdominal hysterectomy, Arthritis, Cellulitis, Otitis media and Sinusitis infections, Endometritis, Endophthalmitis, Gonorrhea, Intra abdominal infections, Neutropenic fever, Osteomyelitis, PID, Pneumonia, Sepsis, surgical prophylaxis, UTI, vaginal hysterectomy.

Don't use for

Class

Penicillin.