Piperacillin-tazobactam

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Background

Clinical Breakpoints

Species ECV (μg/mL) Breakpoints (μg/mL) Breakpoints (mm)
S I R S I R
Enterobacterales ≤16/4 32/4-64/4 ≥128/4 ≥21 18-20 ≤17
Pseudomonas aeruginosa ≤16/4 32/4-64/4 ≥128/4 ≥21 15-20 ≤14
Acinetobacter ≤16/4 32/4-64/4 ≥128/4 ≥21 18-20 ≤17
Other non-Enterobacterales ≤16/4 32/4-64/4 ≥128/4
Anaerobes ≤16/4 32/4-64/4 ≥128/4
Haemophilus influenzae and Haemophilus parainfluenzae ≤1/4 ≥2/4 ≥21
Gram-positive bacteria susceptibility predicted by penicillin

Dosing

  • Standard dose: 3.375 g IV every 6 hours
  • Pseudomonas dose: 4.5 g IV every 6 hours

Renal Dosing

CrCl Standard Pseudomonas Notes
>30 3.375 g q6h 4.5 g q6h
10-29 3.375 g q8h 4.5 g q8h
<10 3.375 g q12h 4.5 g q12h
PD 3.375 g q12h 4.5 g q12h
HD 3.375 g q12h 4.5 g q12h On dialysis days, given towards the end of dialysis
CRRT 3.375 g q6h 4.5 g q6h
SLED 3.375 g q12-18h 4.5 g q12-18h Depends on severity of illness and intensity of SLED dialysis