📋 Indications & Clinical Dosage
*Pneumonia, Septicaemia, Complicated infections of urinary-tract, respiratory tract, abdominal, skin & soft-tissues:*
BY SLOWIV INJ OR IV INF: Adult: 4.5 g every 8 hours; increased if necessary to4.5 g every 6 hours, increased frequency may be used for severe infections.
*Infections in neutropenic patients:*
BY SLOW IV INJ OR IV INF: Adult: 4.5 g every 6 hourswith aminoglycosides.
Children: 90 mg/kg 6 hourly with aminoglycosides; max 4.5 gm six hourly.
*Appendicitis:*
BY SLOWIV INJ OR IV INF: Adult: 4.5 g every 8 hours; increased if necessary to4.5 g every 6 hours.
Children 2-12 yr: 112.5 mg/kg eight hourly; max 4.5 gm eight hourly.
💊 Mode of Administration
IV: Administer by IV infusion over 30 min. Use single-dose vials immediately after reconstitution (discard unused portions after 24 hours at room temperature and 48 hours if refrigerated). Reconstitute with 5 ml of diluent per 1 gm of piperacillin and then further dilute. Compatible diluent include NS, SWFI, dextran 6%, D5W, D5W with potassium chloride 40 mEq, bacteriostatic saline and water.
⛔ Contraindications
Hypersensitivity to penicillins, cephalosporins or other beta-lactams.
⚠️ Precautions & Warnings
Renal or hepatic failure, patients with low K+ reserves.High doses may lead to hypernatraemia
🔄 Drug Interactions
Probenecid, drugs affecting blood Coagulation and/or thrombocyte function, non-depolarising muscle re-laxants, methotrexate.
⚠️ Adverse Reactions / Side Effects
GI disturbances, nausea, vomiting, constipation, dyspepsia, headache, hypotension, injection-site reactions, insomnia, jaundice, stomatitis. Rare: eosinophilia, hepatitis, hypoglycaemia, hypokalaemia, pancytopenia, Steven-Johnson syndrome, toxic epidermal necrolysis, allergic re-actions
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Caution advised, avoid
Lactation / Breastfeeding:
Caution advised
🧪 Compatibility & Storage Stability
Compatibility: Stable in dextran 6% in NS, D5W, NS, SWFI, bacteriostatic water. Incompatible with LR.
Stability & Storage: Store at controlled room temperature. After recon-stitution, solution is stable in NS or D5W for 24 hours at room temperature and 7 days when refrigerated.