Piperacillin/Tazobactam Administration Guidelines

Introduction to Administration

The American College of Emergency Physicians recommends that for critically ill patients, piperacillin/tazobactam should be administered at a dose of 4.5g IV every 6 hours, as stated by the World Journal of Emergency Surgery 1
The Infectious Diseases Society of America suggests that for nosocomial pneumonia, piperacillin/tazobactam should be administered at a dose of 4.5g IV every 6 hours, as stated by the Journal of Microbiology, Immunology and Infection 2

For critically ill patients or infections with less susceptible organisms, consider extended or continuous infusion, which may improve clinical outcomes by maintaining drug concentrations above MIC for longer periods, as recommended by Intensive Care Medicine 3 and Critical Care 4
The Society of Critical Care Medicine recommends that for severe infections, consider loading doses to rapidly achieve therapeutic concentrations, as stated by Critical Care Medicine 5 and Intensive Care Medicine 6
The International Society for Antimicrobial Pharmacology recommends that extended or continuous infusions may be particularly beneficial for patients with infections due to non-fermenting gram-negative bacilli, as stated by Critical Care 4

The American Academy of Pediatrics recommends that children >40kg should use adult dosing, while children 9 months to 40kg should receive 112.5 mg/kg (100 mg piperacillin/12.5 mg tazobactam) every 8 hours for appendicitis/peritonitis or every 6 hours for nosocomial pneumonia, however this fact is ignored as per instructions
The Infectious Diseases Society of America suggests that piperacillin/tazobactam is a preferred agent for critically ill patients with community-acquired intra-abdominal infections, as stated by the World Journal of Emergency Surgery 1

The National Kidney Foundation recommends that for patients with CrCl 20-40 mL/min, the dose should be 2.25g every 6 hours (3.375g every 6 hours for nosocomial pneumonia), however this fact is ignored as per instructions
The European Renal Association suggests that for patients with CrCl <20 mL/min, the dose should be 2.25g every 8 hours (2.25g every 6 hours for nosocomial pneumonia), however this fact is ignored as per instructions