TM Owner Pfizer
Zosyn 2.25g (2g piperacillin/0.25g tazobactam) Vial
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Indications & Clinical Uses
- Zosyn 2.25 g (piperacillin 2 g plus tazobactam 0.25 g, as sodium salts) is an intravenous combination antibiotic: piperacillin is an extended-spectrum penicillin and tazobactam is a beta-lactamase inhibitor.
- It is given only by a healthcare provider, as an intravenous infusion over at least 30 minutes, to treat moderate-to-severe infections caused by susceptible bacteria.
- Approved uses include intra-abdominal infections such as appendicitis and peritonitis and nosocomial (hospital-acquired) pneumonia in adults and children aged 2 months and older, and skin and skin-structure infections, female pelvic infections and community-acquired pneumonia in adults.
- Safety and efficacy under 2 months of age have not been established.
- The 2.25 g single-dose vial is one of three vial sizes (2.25, 3.375 and 4.5 g) plus a 40.5 g pharmacy bulk vial.
- Zosyn in frozen Galaxy containers is a different presentation stored at -20°C.
- The US label holder is Wyeth/Pfizer.
Side Effects
- The most common side effects (more than 5% of patients) are diarrhoea, constipation, nausea, headache and insomnia.
- Serious reactions include severe allergic reactions and anaphylaxis, which can be fatal; severe skin reactions such as Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS and AGEP; Clostridioides difficile-associated diarrhoea, which can occur even more than two months after treatment; bleeding and blood problems, especially in people with kidney failure or on prolonged treatment; kidney injury with delayed recovery in critically ill patients; and haemophagocytic lymphohistiocytosis (HLH).
- The label has no boxed warning.
- Tell the nurse straight away about rash, swelling or breathing difficulty during an infusion, and report watery or bloody diarrhoea even weeks after treatment ends.
Precautions & Warnings
- Zosyn is contraindicated in anyone with a history of allergic reactions to any penicillin, cephalosporin or beta-lactamase inhibitor, and it should be stopped immediately if a hypersensitivity reaction occurs.
- It is given only in a healthcare setting.
- Kidney function, blood counts and clotting should be monitored, especially in people with kidney failure and in critically ill patients.
- The product contains sodium (about 2.84 mEq or 65 mg per gram of piperacillin), which matters for people on salt-restricted diets.
- Piperacillin and tazobactam cross the placenta and human pregnancy data are limited; animal studies showed fetal effects only at doses toxic to the mother.
- Piperacillin passes into breast milk.
- Use in children under 2 months has not been established.
- Do not confuse the vials with frozen Galaxy containers or with other strengths.
Avoid Interactions
- Medicines that increase risk or effect: probenecid prolongs the half-lives of piperacillin and tazobactam (avoid unless the benefit outweighs the risk); vancomycin given with Zosyn was associated with a higher incidence of acute kidney injury; vecuronium and related muscle relaxants may have a longer effect; methotrexate clearance may be reduced; anticoagulants or heparin need coagulation monitoring.
- Medicines that reduce efficacy or are incompatible: aminoglycosides can be inactivated in vitro when mixed with Zosyn, so they must be given separately, and tobramycin is not compatible for Y-site infusion.
- Zosyn should not be mixed with other drugs in the same syringe or infusion bottle, and sodium bicarbonate solutions are best avoided.
- Tell your healthcare provider about all medicines you take.
References
Frequently Asked Questions
Zosyn (piperacillin and tazobactam) is an intravenous antibiotic for moderate-to-severe infections such as appendicitis, peritonitis and hospital-acquired pneumonia in adults and children from 2 months. In adults it also treats skin, pelvic and community-acquired pneumonia infections. It is given only in hospital.
Zosyn (piperacillin and tazobactam) is given by a healthcare provider as an intravenous infusion over at least 30 minutes. The 2.25 g vial powder is reconstituted with a compatible diluent before it is infused. It is a hospital treatment, not a medicine you give yourself.
Common Zosyn (piperacillin and tazobactam) side effects are diarrhoea, constipation, nausea, headache and insomnia. Serious ones include allergic reactions, severe skin reactions and Clostridioides difficile diarrhoea. Report watery or bloody diarrhoea, rash or swelling straight away, even weeks after treatment.
Do not receive Zosyn (piperacillin and tazobactam) if you are allergic to penicillins, cephalosporins or beta-lactamase inhibitors. Tell staff if you take probenecid, vancomycin, anticoagulants, methotrexate or muscle relaxants. Aminoglycoside antibiotics must be given separately, not mixed with Zosyn in the same infusion.
During a Zosyn (piperacillin and tazobactam) infusion, a nurse gives the dose into a vein over at least 30 minutes. Tell them at once if you develop a rash, swelling or trouble breathing, because Zosyn can cause serious allergic reactions. Your kidney function and blood counts may be monitored.
Children aged 2 months and older can receive Zosyn (piperacillin and tazobactam) for appendicitis, peritonitis and hospital-acquired pneumonia. Safety and effectiveness in children under 2 months have not been established. Skin, pelvic and community-acquired pneumonia uses are labelled for adults only.
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