Perhaps you or someone in your family has been hospitalized, and the doctor has come and said, "The infection is a bit severe, let's start a strong intravenous antibiotic." At such times, one of the most commonly used and important drugs in our country and around the world is this injection, which is a combination of two drugs called Piperacillin and Tazobactam. You may have heard of it by the brand name Zosyn. So today, let's talk very simply about what this drug is, what it does, and what we need to be careful about while taking it.
Simply put, what is Piperacillin; Tazobactam?
This is a powerful antibiotic . This means that this medicine can kill bacteria that enter our body and cure infections caused by them. It belongs to a group of drugs called Penicillin. You may have heard of Penicillin before.
But here is where many people make a mistake. This medicine only works for bacterial infections . It has no effect on viral infections like the common cold, flu, cough, and COVID-19. Therefore, this is a medicine that should only be used if prescribed by a doctor. For example, it is mainly given for severe bacterial infections like pneumonia, urinary tract infections, severe skin infections, and intra-abdominal infections.
Things you need to tell your doctor before starting this medication
This is very important. It is essential that your doctor knows your complete health history before deciding to give you this injection. Be sure to tell them about any of the following conditions, especially if you have any:
| Your situation | Why do you need to tell the doctor about it? |
|---|---|
| Allergies to any medicine | This is the most important thing. Especially if you have had a previous allergy to Penicillin or another antibiotic in the Cephalosporin group, which can be life-threatening. Also, tell us about any other allergies you have to any medications, foods, or dyes. |
| Kidney disease | This medicine is mainly eliminated from the body through the kidneys. So if your kidneys are not functioning properly, the dose of the medicine should be adjusted accordingly. Otherwise, the medicine may accumulate in the body and increase the side effects. |
| Blood clotting or bleeding disorders | This medicine can sometimes have a small effect on the blood clotting process, so if you already have a bleeding problem, it's important to let your doctor know. |
| Low potassium level | This medication may further decrease potassium levels in the body. Therefore, if you already have such a condition, you should pay extra attention to it during treatment. |
| Stomach or intestinal problems (e.g., colitis) | Some antibiotics can cause inflammation of the intestines (colitis). Tell your doctor if you have a history of this. |
| If you are pregnant or trying to conceive | Any medication should be taken with extreme caution during pregnancy. So if you are in this situation, inform your doctor. |
| If you are a breastfeeding mother | A very small amount of this medicine can pass into breast milk. So if you are a breastfeeding mother, talk to your doctor about that too. |
How do you use this medicine?
This medicine is given as an injection into a vein (intravenous or IV injection) . This is usually given by a medical staff member in a hospital or clinic. The medicine is diluted and then injected into the body through a saline solution.
However, in some severe cases of infection, you may need to continue this treatment at home after you leave the hospital. If this is the case, you or your caregiver will be trained on how to do it properly, prepare the medicine, and give the injection.
The most important thing is to take this medicine for the full number of days your doctor prescribes. Don't stop half way through thinking, "I'm feeling better now." If you do, the infection may not be completely cured and may come back.
If you are using this medicine at home, never throw used needles and syringes in the trash. They should be placed in a special container (`sharps container`) provided. If you don't have one, ask your doctor how to get one.
Can this medicine be given to small children?
Yes. This medicine is also recommended for children over 2 months of age in some special cases. But it is done under the strict supervision of a pediatrician, with great care.
What to do if the medication dose is increased?
If you think you have accidentally taken more than the prescribed dose, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital .
What to do if you miss a dose of medication?
- If at the hospital: They will make sure you get your medicine on time. If for some reason you can't make it to the clinic on time, let them know in advance.
- At home: If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Do not take two doses at once for any reason.
What other medications may interact with this medicine?
Yes, some medications can interact with Piperacillin; Tazobactam. Therefore, tell your doctor about all the medications you are taking (including vitamins, herbal remedies, and supplements).
| Type of medicine | Description |
|---|---|
| Blood thinners | If you take medications like Warfarin, Heparin, and Aspirin, the risk of bleeding may increase. |
| Methotrexate | This medicine, which is used to treat cancer and some rheumatic diseases, can interact with Piperacillin in the body and increase side effects. |
| Probenecid | This medicine, which is given for gout, delays the elimination of Piperacillin from the body, and its levels may increase. |
| Vancomycin | This is another powerful antibiotic. When these two are given together, there is a slightly higher chance of kidney damage. |
| Vecuronium | Piperacillin may alter the effectiveness of medications such as these used for anesthesia during surgery. |
Things to consider during treatment
- Pay attention to symptoms: Tell your doctor if your symptoms are decreasing or getting worse.
- Skin changes: Some severe skin reactions may occur even weeks after starting this medicine. If you notice any redness, blistering, peeling of the skin along with fever, body aches, or other symptoms , tell your doctor immediately. Also, watch out for swelling of the face, lips, or lumps in the neck or armpits.
- Diarrhea: It's normal for some people to get diarrhea when taking antibiotics. However, if you have severe, watery diarrhea that lasts more than two days, talk to your doctor instead of taking over-the-counter medication.
- For people with diabetes: If you are being treated for diabetes, a false-positive urine sugar test may occur while taking this medication. So talk to your doctor about the best way to manage your diabetes.
Side effects that may occur due to medication
Like any medicine, this one can have some side effects. But not everyone gets them. Let's break these down into two categories.
| If these symptoms occur, seek medical advice immediately. | |
|---|---|
| Severe allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat, difficulty breathing. |
| Severe skin symptoms | Skin redness, blistering, peeling (even inside the mouth). |
| Effects on the kidneys | Decreased urine output, swelling of the ankles, hands, or feet. |
| Severe diarrhea | Watery diarrhea, fever, stomach ache. |
| Other | Seizures, abnormal vaginal discharge or itching. |
| Things to tell your doctor if you see it regularly, but it persists | |
| Digestive system problems | Common diarrhea, constipation, nausea. |
| Other minor features | Headache, difficulty sleeping, pain or redness where the injection was given. |
Take-Home Message
- Piperacillin; Tazobactam is a powerful antibiotic that is only given for bacterial infections. It is not useful for the common cold.
- If you have any allergies to penicillin or anything else, be sure to tell your doctor before starting the medication.
- Also inform your doctor about other medical conditions, such as kidney disease and bleeding problems.
- Take the medicine for the full number of days prescribed by the doctor. Do not stop halfway.
- If you experience symptoms such as severe skin rashes or severe diarrhea during treatment, inform your doctor immediately.
- This medicine is for you only. Never share it with others.
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