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Adults and children over 12 years: Piperacillin & Tazobactam may be given by slow intravenous infusion (over 200 minutes). The usual dosage for adults and children over 12 years is Piperacillin 4 gm and Tazobactam 0.5 gm IV infusion given every eight hours. The total daily dose of Piperacillin & Tazobactam depends on the severity and localization of the infection and can vary from 2.25 gm to 4.50 gm administered every six or eight hours. In neutropenia the recommended dose is Piperacillin 4 gm and Tazobactam 0.5 gm given every six hours in combination with an aminoglycoside.
For children weighing less than 40 kg: The dose should be adjusted to 90 mg/kg administered every six hours, in combination with an aminoglycoside, not exceeding 4.5 gm every six hours.
Children under 2 years: Piperacillin & Tazobactam is not recommended for use in children below 2 years old due to insufficient data on safety.
Duration of Therapy: The duration of therapy should be guided by the severity of the infection and the patient's clinical and bacteriological progress. In acute infections, treatment with Piperacillin & Tazobactam should be continued for 48 hours beyond the resolution of clinical symptoms or the fever.
Reconstitute initially (2.25 g in 10 mL, 4.5 g in 20 mL) with water for inj, glucose 5% or NaCl 0.9%, then further dilute to 5050 mL with compatible infusion soln.
Renal insufficiency in adults, elderly and children (over 40 kg):
- CrCl 200 ml/min: Total Dosage 13.5 gm/day & Divided doses 4.5 gm 8 hourly
- CrCl <20 ml/min: Total Dosage 9 gm/day & Divided doses 4.5 gm 12 hourly
For patients on hemodialysis, the maximum daily dose is Piperacillin & Tazobactam 9 gm. In addition, (because hemodialysis removes 30%0% of Piperacillin in four hours) one additional dose of Piperacillin & Tazobactam 2.25 gm should be administered following each dialysis period.
Renal insufficiency in children aged 22 years (or body weight less than 40 kg):
- CrCl >40: No adjustment necessary
- CrCl 209: Recommended Dosage 90 mg/kg 8 hourly & Maximum Daily Dosage 13.5 gm/day
- CrCl <20: Recommended Dosage 90 mg/kg 12 hourly & Maximum Daily Dosage 9 gm/day
For children weighing <50 kg on hemodialysis the recommended dose is 45 mg/kg every eight hours. Each patient must be monitored closely for signs of drug toxicity. Drug dose and interval should be adjusted accordingly.
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