Piperacillin–tazobactam: a β-lactam/β-lactamase inhibitor combination

  title={Piperacillin–tazobactam: a $\beta$-lactam/$\beta$-lactamase inhibitor combination},
  author={Alfred S. Gin and Leanne Dilay and James A. Karlowsky and Andrew J. Walkty and Ethan Rubinstein and George G. Zhanel},
  journal={Expert Review of Anti-infective Therapy},
  pages={365 - 383}
Piperacillin–tazobactam is a β-lactam/β-lactamase inhibitor combination with a broad spectrum of antibacterial activity that includes Gram-positive and -negative aerobic and anaerobic bacteria. Piperacillin–tazobactam retains its in vitro activity against broad-spectrum β-lactamase-producing and some extended-spectrum β-lactamase-producing Enterobacteriaceae, but not against isolates of Gram-negative bacilli harboring AmpC β-lactamases. Piperacillin–tazobactam has recently been reformulated to… 

Three Decades of β-Lactamase Inhibitors

The mechanisms of action and salient clinical and microbiological features of β-lactamase inhibitors are highlighted and novel compounds and the chemical features of these agents that may contribute to a “second generation” of inhibitors are focused on.

Ceftazidime-Avibactam: a Novel Cephalosporin/β-lactamase Inhibitor Combination

Pharmacodynamic data suggest that ceftazidime-avibactam is rapidly bactericidal versus β-lactamase-producing Gram-negative bacilli that are not inhibited by ceftAZidime alone.

Role of beta lactamases in antibiotic resistance: A review

This review describes the various β - lactum antibiotics and effect of diffe rent β – lactamases that produced by the sever al bacteria against the β- lactam antibiotics, their resistance pattern and its effective management with combination therapy.

β-Lactam Antibiotics

This review traces the historical development of β-lactam drug discovery, with emphasis on the most recent progress in the medicinal chemistry, biochemistry, and microbiology of the β-Lactams leading to the discovery of new generation β- lactam antibacterials effective against the Gram-negative and -positive bacterial pathogens of current medical concern.

Emerging Strategies to Combat β-Lactamase Producing ESKAPE Pathogens

Several promising alternative approaches such as bacteriophages, antimicrobial peptides, nanoparticles, CRISPR (clustered regularly interspaced short palindromic repeats) cas technology, or vaccination developed to limit antimicrobial resistance in this endless fight against Gram-negative pathogens are discussed.

Ertapenem versus piperacillin/tazobactam for the treatment of complicated infections: a meta-analysis of randomized controlled trials

Evidence is provided that ertapenem 1 g once a day can be used as effectively and safely as recommended dose of piperacillin/tazobactam, for the treatment of complicated infections, particularly of mild to moderate severity.

Determination of Piperacillin/Tazobactam and Ticarcillin/ClavulanateSusceptibilities in Pseudomonas aeruginosa Isolates in Hospitalised Patients by E-test Gradient Method and Comparison of Results with Disk Diffusion Tests

The results of this study suggest that it would be more appropriate to use E-test method to confirm the results of the isolates which were found to be resistant against PIP/TZP by disk diffusion method.

Pharmacokinetics-Pharmacodynamics of Tazobactam in Combination with Piperacillin in an In Vitro Infection Model

D dose fractionation studies designed to evaluate the PK-PD index associated with tazobactam efficacy, when given in combination with piperacillin, and the impact of the presence of a different β-lactam agent, or different blaCTX-M-15 transcription levels, on the magnitude of the taz obactam PK- PD index necessary for efficacy are described.



Comparative in vitro and in vivo activities of piperacillin combined with the beta-lactamase inhibitors tazobactam, clavulanic acid, and sulbactam.

Tazobactam and clavulanic acid were superior to sulbactam in enhancing the therapeutic efficacy of piperacillin in mice infected with beta-lactamase-positive E. coli, K. pneumoniae, Proteus mirabilis, and Staphylococcus aureus.

Ertapenem: review of a new carbapenem

Clinical trials of complicated intra-abdominal infection, acute pelvic infection, complicated skin and soft-structure infection, community-acquired pneumonia and complicated urinary tract infections demonstrated that ertapenem has equivalent efficacy and safety compared with ceftriaxone and piperacillin/tazobactam.

Extended-Spectrum β-Lactamases: a Clinical Update

Extended-spectrum β-lactamases represent an impressive example of the ability of gram-negative bacteria to develop new antibiotic resistance mechanisms in the face of the introduction of new antimicrobial agents.

Pharmacokinetics-Pharmacodynamics of Cefepime and Piperacillin- Tazobactam against Escherichia coli and Klebsiella pneumoniae Strains Producing Extended-Spectrum β-Lactamases: Report from the ARREST Program

The data suggest that the probability of achieving T>MIC target attainment rates is generally higher with cefepime than with piperacillin-tazobactam for present-day ESBL-producing strains when one uses contemporary dosing regimens.

Extended-Spectrum β-Lactamases and Clinical Outcomes: Current Data

A critical examination of the literature provides divergent views of the effect of ESBL carriage on morbidity and mortality and suggests that ESBL production may have its most marked effect on ceftazidime.

In Vitro Activities of Piperacillin against β-Lactamase-Negative Ampicillin-Resistant Haemophilus influenzae

PIP showed excellent activities against BLNAR strains in a manner different from those of cephem antibiotics, suggesting that it could be a candidate therapeutic agent for the treatment of meningitis caused by BLNar strains.

Pharmacokinetic characteristics of piperacillin/tazobactam

Findings show that piperacillin/tazobactam is a truly synergistic combination which can be expected to be effective in treating a wide variety of infections in the clinical setting.

Resistance to β-lactam antibiotics

  • K. Poole
  • Biology, Chemistry
    Cellular and Molecular Life Sciences CMLS
  • 2004
Approaches for overcoming resistance mechanisms include the development of novel β-lactamase-stable β- lactams, β-Lactam enzyme inhibitors to be employed with existing β- Lactamams, compounds that bind strongly to low-affinity PBPs and agents that potentiate the activity of existing β -lactams against low-Affinity PBP-producing organisms.

Ertapenem Versus Piperacillin/Tazobactam in the Treatment of Complicated Intraabdominal Infections: Results of a Double-Blind, Randomized Comparative Phase III Trial

The results of this trial suggest that ertapenem may be a useful option that could eliminate the need for combination and/or multidosed antibiotic regimens for the empiric treatment of intraabdominal infections.