Piperacillin sodium is a
beta lactam antibiotic with a broad range of antibacterial activity that includes gram-negative bacilli, gram-positive cocci (except
penicillinase-producing S. aureus) and anaerobic pathogens such as Clostridium difficile, and Bacteroides fragilis.
Piperacillin inhibits many of the members of the Enterobacteriaceae, including Klebsiella sp and Pseudomonas, at lower concentrations than required for
carbenicillin and
ticarcillin.
Piperacillin sodium is administered by intramuscular and
intravenous injection and is widely distributed throughout body fluids and tissues. Like other newer
penicillins,
piperacillin is excreted by both renal and biliary mechanisms. The primary route of elimination is by glomerular filtration, which results in high urinary concentrations of the unchanged compound.
Piperacillin has been approved for patients with serious
infection caused by susceptible strains of specific organisms in intra-abdominal, urinary tract, gynecologic, lower respiratory tract, skin and skin structure, bone and joint, and gonococcal
infections and
septicemia. As with other
penicillins,
piperacillin has a low frequency of toxicity. The usual dose of
piperacillin in adults with serious
infections with normal renal function is 3-4 g every 4-6 hr as a 20-30 min infusion, with a maximum dose of 24 g per day. It is stable in most large volume parenteral solutions. Less serious infectins (requiring smaller dosages) may be treated by
intramuscular injection; however, no more than 2 g should be given at any one injection site. Overall,
piperacillin has a greater degree of activity than other
penicillins. Evidence from prospective studies indicates that
piperacillin is a highly effective agent for the treatment of patients with
infections caused by susceptible organisms.