Piperacillin/tazobactam (Zosyn) EXTENDED INFUSION

Dosing: Adult Antimicrobial Dosing, Non-dialysis

Indication CrCl > 20 mL/min <20 mL/min

UCSF: All Infections, including documented/suspected Pseudomonas 

Exclusion criteria for EXTENDED INFUSION: resistant or intermediate susceptibility organism, cystic fibrosis, peri-procedural areas, insufficient IV access

ZSFG: Use EXTENDED INFUSION when recommended by ID pharmacist or ID fellow

Loading dose = 4.5 g IV over 30 min x1, then 4.5 g IV infused over 4h every 8h (starting 4h after loading dose) Use SHORT INFUSION piperacillin/tazobactam

Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis

Indication

Intermittent Hemodialysis

Continuous Hemodialysis

All Infections, including documented/suspected Pseudomonas 

Exclusion criteria for EXTENDED INFUSION: resistant or intermediate susceptibility organism, cystic fibrosis, peri-procedural areas, insufficient IV access

Use SHORT INFUSION piperacillin/tazobactam

UCSF: Loading dose = 4.5 g IV over 30 min x1, then 4.5 g IV infused over 4h every 8h (starting 4h after loading dose)

ZSFG: Contact ID pharmacy

Dialysis Notes

Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min.  For detailed view of dialysis dosing and evidence, see Dosing in Hemodialysis document.

UCSF: PREFERRED dosing strategy if no exclusions

ZSFG: Available upon ID pharmacy or ID fellow recommendation

References: