Zosyn

BACKGROUND: Dodecapeptide SC4 is a broad-spectrum bactericidal agent that functions by disintegrating bacterial membranes and neutralizing endotoxins. For insight into which SC4 amino acids are functionally important, we assessed Gram-negative bactericidal effects in structure-activity relationship experiments. Subsequently, SC4 was tested in a murine bacteremia model to combine and compare the efficacy with Zosyn, a first-line antibiotic against Pseudomonas aeruginosa (P. aeruginosa)...

We report an incidental finding of absent liver uptake of (99m)Tc leukocyte scan in an alcoholic patient with acute Zosyn (piperacillin and tazobactom)-related drug reaction with eosinophilia and systemic symptoms, persistent elevated white blood cell counts, and negative blood culture. Alcoholic steatohepatitis was confirmed in this patient through further clinical examination, blood test, and CT imaging.

BACKGROUND: Abnormal cardiac repolarization, indicated by a prolongation of the QT interval, increases the risk for torsades de pointes, a potentially life-threatening arrhythmia. Many perioperatively administered drugs and conditions prolong the QT interval. Despite several reports of perioperative torsades de pointes, systematic evidence regarding perioperative QT interval prolongation is limited. METHODS: Serial postoperative 12-lead electrocardiograms were obtained from 469 adult patients undergoing major noncardiac surgery under general anesthesia...

Tobramycin is an aminoglycoside antibiotic that loses a significant amount of activity in the presence of Zosyn at pH 6. As part of our investigation into ways to improve the compatibility of tobramycin with Zosyn (which contains piperacillin and tazobactam in an 8:1 ratio buffered at pH 6 by sodium citrate) by lowering the pH, we identified the reaction product of tobramycin and piperacillin at pH 6.0 and the order of the pK(a) values of tobramycin. The structure of the main reaction product of tobramycin and piperacillin at pH 6...

The experience with analyzing the potency of piperacillin/tazobactam generic formulations by a precise multiorganism in vitro assay was expanded to 46 lots (29 manufacturers, 17 countries). Across all generic lots, the range of activity compared with a reference branded lot (RLOT; Zosyn; Wyeth Pharmaceuticals, Philadelphia, PA) was +10% to -42% (average, -16%). Eight lots of Zosyn were also tested with a range of +7 to -19 (average, only -6%), and the reproducibility (13 replicates) of the RLOT assay was confirmed (+/-3%)...

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Acute generalized exanthematous pustulosis (AGEP) is a rare disorder characterized by an acute episode and sudden onset of erythematous and edematous eruptions of hundreds of sterile pustules. It is a self-limiting condition accompanied by fever and has a rapid course. It is mostly caused by drugs especially antibiotics. It is diagnosed by skin biopsy, which shows intracorneal pustules and neutrophilic infiltration in dermis and epidermis. We report a case of a patient who developed this rare skin condition with the use of piperacillin/tazobactam (Zosyn)...

Zosyn((R)) , also known as Tazocin((R)) for injection, contains piperacillin and tazobactam and was approved by the US Food and Drug Administration in 1993 for the treatment of indicated serious infections. In 1995, United States Pharmacopoeia and European Pharmacopoeias reduced the particulate limit for injectables by 40%, based on general safety concerns. Wyeth attempted to control sporadic batch failures (associated with increased particulate formation) by shortening product expiration dating from 36 to 24 months and optimizing the stopper siliconization process...

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Twenty-three generic intravenous piperacillin/tazobactam products were compared for in vitro activity to the branded formulation (Zosyn, Wyeth, Philadelphia, PA) by disk diffusion and incremental broth microdilution assay methods. All but 1 lot demonstrated significantly decreased activity (-5 to -35%), necessitating further investigations regarding the chemical purity, potency, and therapeutic equivalence of these products worldwide. The average -16% activity across all generic lots was equivalent to underdosing piperacillin/tazobactam by 2...

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BACKGROUND AND OBJECTIVES: Sera containing antibodies to penicillin and penicillin-related drugs are typically thought to react with drug-coated red blood cells (RBCs) (drug adsorption method), but not when the sera are added to drug and RBCs in the same tube ('immune complex' method). Two cases of immune haemolytic anaemia caused by anti-piperacillin have been previously described. Serological details were given in only one patient. In that subject, the antibody was immunoglobulin (Ig)M + IgG and reacted by both the drug adsorption and 'immune complex' methods...

Fifty diabetic patients with hand infections were studied retrospectively. The cause of infection varied, and the infections were divided into two groups: superficial infections and abscesses. The amputation rate was 14%. Only patients who presented with an abscess required amputation, and of those patients with abscesses, 17.5% required amputation. Eighteen of 38 cultured infections were polymicrobial, 4 contained Enterococcus, 11 contained gram-negative bacteria, and 3 contained anaerobic organisms. Bacteriologic culture analysis initiated a two-drug protocol: ampicillin with sulbactam (Unasyn; Pfizer, New York, NY) or piperacillin with tazobactam (Zosyn; Lederle, Pearl River, NY) and gentamicin (renal adjusted)...

The compatibility of piperacillin sodium plus tazobactam with selected drugs during simulated Y-site administration was studied. A 5-mL sample of piperacillin sodium 40 mg/mL plus tazobactam 5 mg/mL (Zosyn) in 5% dextrose injection was combined with a 5-mL sample of each of 75 other drugs at concentrations used clinically. Each combination was prepared in duplicate in glass culture tubes, with the order of mixing being reversed between the duplicates; storage was in constant fluorescent light at 22 degrees C...

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