Highest Recommended Dosage of Zosyn (Piperacillin/Tazobactam)

Adult Dosing Guidelines

The highest recommended dosage of Zosyn (piperacillin/tazobactam) for adults with serious infections is 4.5 grams administered intravenously every 6 hours, with a maximum daily dose of 18 grams of piperacillin component (24 grams per day total) 1, 2
For serious infections such as septicemia, nosocomial pneumonia, and complicated intra-abdominal infections, the recommended dose is 3.375-4.5g IV every 6-8 hours 3, 4
For necrotizing infections of skin, fascia, and muscle, the recommended dose is 3.37g every 6-8 hours IV 5
For mixed infections requiring broad coverage, the recommended dose is 4.5g IV every 6 hours 3, 4
For hospital-acquired pneumonia/ventilator-associated pneumonia, the recommended dose is 4.5g IV every 6 hours 3
For complicated intra-abdominal infections, the recommended dose is 3.375-4.5g IV every 6 hours 3
For skin and soft tissue infections, the recommended dose is 3.37g IV every 6-8 hours 5, 6

For neonates with postmenstrual age >30 weeks, the recommended dose is 80 mg/kg/dose of piperacillin component IV every 6 hours 1, 2
For children, the recommended dose is 240-300 mg/kg/day of piperacillin component IV in 3-4 divided doses 1, 2
The maximum pediatric dose is 4000 mg per dose 1

For nosocomial pneumonia, the recommended dose is 4.5 g IV every 6 hours, as suggested by the Infectious Diseases Society of America 7, 8
For complicated intra-abdominal infections, a dose of 3.375-4.5 g IV every 6 hours is recommended, according to the Clinical Infectious Diseases guidelines 9

For severe infections, extended infusion (3-4 hours) or continuous infusion may be considered to maintain plasma concentrations above MIC for at least 70% of the dosing interval, as recommended by the Society of Critical Care Medicine 10, 11
Maintaining plasma concentrations of piperacillin above MIC for at least 70% of the time increases success rates in critically ill patients with severe infections, as suggested by the European Society of Intensive Care Medicine 11