Piperacillin-Tazobactam Coverage and Guidelines

Spectrum of Activity and Clinical Guideline Support

The World Health Organization recommends piperacillin-tazobactam for severe intra-abdominal infections as a second-choice agent, and for high-risk or severely ill adults with intra-abdominal infections, and for hospital-acquired infections without critical illness but with risk of multidrug-resistant organisms 2, 3
The Infectious Diseases Society of America guidelines recommend piperacillin-tazobactam for empiric coverage of gram-negative bacilli in critically ill patients, those with sepsis, neutropenic patients, or those with femoral catheters 1, 4
Piperacillin-tazobactam has in vitro activity against Salmonella enterica 1

Piperacillin-tazobactam has reduced efficacy against extended-spectrum beta-lactamase (ESBL)-producing organisms, such as MDR Klebsiella pneumoniae and E. coli, and against carbapenemase-producing organisms 1, 4
The IDSA guidelines recommend considering carbapenems instead of piperacillin-tazobactam if ESBL-producing organisms are suspected based on local epidemiology or prior patient colonization 1, 4