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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/12/19 18:24:18」(JST)

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Piperacillin/tazobactam, sold under the brand name Tazocin among others, is a combination medication containing the antibiotic piperacillin and the β-lactamase inhibitor tazobactam.^[1] The combination has activity against many Gram-positive and Gram-negative bacteria including Pseudomonas aeruginosa.^[1] It is used to treat pelvic inflammatory disease, intraabdominal infection, pneumonia, cellulitis, and sepsis.^[1] It is given by injection into a vein.^[2]

Common side effects include headache, trouble sleeping, rash, nausea, constipation, and diarrhea.^[1] Serious side effects include Clostridium difficile infection and allergic reactions including anaphylaxis.^[1] Those who are allergic to other β-lactam are more likely to be allergic to piperacillin/tazobactam.^[1] Use in pregnancy or breastfeeding appears to generally be safe.^[3] It usually results in bacterial death through blocking their ability to make a cell wall.^[1]

Piperacillin/tazobactam was approved for medical use in the United States in 1993.^[1] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.^[4] It is avaliable as a generic medication.^[2] The wholesale cost in the developing world, as of 2015, is about 11 USD per day.^[5] In the United Kingdom, as of 2015, this amount costs the NHS about 38.70 pounds per day.^[2]

Medical uses

Its main uses are in intensive care medicine (pneumonia, peritonitis), some diabetes-related foot infections, and empirical therapy in febrile neutropenia (e.g., after chemotherapy). The drug is administered intravenously every 6 or 8 hr, typically over 3–30 min. It may also be administered by continuous infusion over four hours. Prolonged infusions are thought to maximize the time that serum concentrations are above the minimum inhibitory concentration (MIC) of the bacteria implicated in infection.

Piperacillin-tazobactam is recommended by the National Institute for Health and Care Excellence as first line therapy for the treatment of bloodstream infections in neutropenic cancer patients.^[6]

Adverse reactions

The most common adverse reaction is diarrhea (7–11%).^[7] One other side effect is inhibition of platelets (thrombocytopenia).^[8]

Society and culture

Trade names

Apart from Tazocin and Zosyn, the drug is marketed in various countries under other trade names such as Tazact, Biopiper TZ, Brodactam, Piptaz, Maxitaz, Kilbac, Trezora, Du-Tazop, Tazopen, Sytaz, and Inzalin TZ.

2017 shortage

Various sources have referred to a shortage of the drug since May 2017, citing various reasons, including an earthquake in China and other issues at the major production facility in 海正 (Hisun); increased demand; withdrawal of funding by a major pharmaceutical company.^[9] ^[10]

References

^ ^a ^b ^c ^d ^e ^f ^g ^h "Piperacillin Sodium and Tazobactam Sodium". The American Society of Health-System Pharmacists. Retrieved 8 December 2017.
^ ^a ^b ^c British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 373. ISBN 9780857111562.
^ "Piperacillin / tazobactam (Zosyn) Use During Pregnancy". Drugs.com. Retrieved 10 December 2017.
^ "WHO Model List of Essential Medicines (20th List)" (PDF). World Health Organization. March 2017. Retrieved 29 June 2017.
^ "Single Drug Information". International Medical Products Price Guide. Retrieved 10 December 2017.
^ "Neutropenic Sepsis: Prevention and Management of Neutropenic Sepsis in Cancer Patients - National Library of Medicine - PubMed Health".
^ "Piperacillin and Tazobactam Sodium". Merck Manual Professional. Archived from the original on November 20, 2010.
^ Rousan TA, Aldoss IT, Cowley BD Jr, Curtis BR, Bougie DW, Aster RH, George JN (January 2010). "Recurrent acute thrombocytopenia in the hospitalized patient: Sepsis, DIC, HIT, or antibiotic-induced thrombocytopenia". 85 (1): 71–74. doi:10.1002/ajh.21536. PMC 4410979 . PMID 19802882.
^ "Drug Shortages › Piperacillin Tazobactam Injection". Drugs.com. 10 July 2017. Retrieved 12 July 2017.
^ "Major shortage forces doctors to ration important antibiotic". RT.com. 1 July 2017. Retrieved 12 July 2017.

UpToDate Contents

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1. 成人における確定診断を得られていない低血圧やショックの評価および初期アプローチ evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock
2. βラクタム系抗生物質の長期注入投与 prolonged infusions of beta lactam antibiotics
3. β-ラクタマーゼ阻害剤、カルバペネム系、およびモノバクタム系抗菌薬の併用 combination beta lactamase inhibitors carbapenems and monobactams
4. 基質特異性拡張型β-ラクタマーゼ extended spectrum beta lactamases
5. 緑膿菌感染症に対する抗菌薬治療の原則 principles of antimicrobial therapy of pseudomonas aeruginosa infections

English Journal

Postoperative QT Interval Prolongation in Patients Undergoing Noncardiac Surgery under General Anesthesia.

Nagele P, Pal S, Brown F, Blood J, Miller JP, Johnston J.Source* Assistant Professor of Anesthesiology and Genetics, Department of Anesthesiology, Washington University, St. Louis, Missouri. † Research Fellow, Department of Anesthesiology, Washington University. ‡ Research Coordinator, Division of Clinical and Translational Research, Department of Anesthesiology, Washington University. § Research Nurse Supervisor, Division of Clinical and Translational Research, Department of Anesthesiology, Washington University. ‖ Professor of Biostatistics, Division of Biostatistics, Washington University. # Resident, Department of Anesthesiology, Washington University.
Anesthesiology.Anesthesiology.2012 Aug;117(2):321-328.
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
PMID 22692379

Broad-spectrum β-lactam antibiotics for treating experimental peritonitis in mice due to Klebsiella pneumoniae producing the carbapenemase OXA-48.

Mimoz O, Grégoire N, Poirel L, Marliat M, Couet W, Nordmann P.SourceINSERM ERI 23 Pharmacology of Antimicrobial Agents, Centre Hospitalier Universitaire de Poitiers, and Université de Poitiers, Poitiers, France.
Antimicrobial agents and chemotherapy.Antimicrob Agents Chemother.2012 May;56(5):2759-60. Epub 2012 Feb 13.
A lethal peritonitis model was induced in mice with a Klebsiella pneumoniae isolate producing the carbapenemase OXA-48. Administration of a single dose (up to 100 mg/kg) of the antibiotic piperacillin-tazobactam, imipenem-cilastatin, ertapenem, or cefotaxime had little or no impact on lethality. Cef
PMID 22330912

Japanese Journal

日本発・世界のくすり(31)日本生まれのペニシリン系薬TAZ/PIPC ゾシン静注用2.25・ゾシン静注用4.5 一般名:注射用タゾバクタムナトリウム・ピペラシリンナトリウム

大正富山医薬品株式会社
医療 63(7), 450-452, 2009-07
NAID 40016774927

β-ラクタマーゼ阻害薬配合抗生物質製剤「注射用タゾバクタムナトリウム・ピペラシリンナトリウム」(ゾシン_【○!R】静注用2.25, ゾシン_【○!R】静注用4.5)の薬理学的特性および臨床効果

宇治達哉,橋本好和
日本薬理学雑誌 133(6), 351-358, 2009-06-01
タゾバクタム・ピペラシリン（ゾシン®静注用2.25，ゾシン®静注用4.5）は，β-ラクタマーゼ阻害薬であるタゾバクタムと広域抗菌スペクトルを有するペニシリン系抗生物質であるピペラシリンを力価比1:8の割合で配合した注射用抗生物質であり，2008年10月より販売されている．本剤は，各種のβ-ラクタマーゼ産生菌を含むグラム陽性菌および緑膿菌などのグラム陰性菌に対して強い抗菌力を有し …
NAID 10025740933

Related Pictures

Object moved Zosyn Yeast Infection Guide Zosyn Antibiotic Drug Class Zosyn In Dextrose (Iso-Osmotic) Intravenous : Uses, Side Effects, Interactions Zosyn Intravenous : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD

★リンクテーブル★

リンク元	「ピペラシリン-タゾバクタム」

「ピペラシリン-タゾバクタム」

Piperacillin/tazobactam
Combination of
Piperacillin	Ureidopenicillin antibiotic
Tazobactam	Beta-lactamase inhibitor
Clinical data
Trade names	Tazocin, Zosyn, others
AHFS/Drugs.com	Monograph
MedlinePlus	a694003
Pregnancy; category	US: B (No risk in non-human studies); ;
Routes of; administration	Intravenous infusion
ATC code	J01CR05 (WHO);
Legal status
Legal status	US: ℞-only;
Identifiers
CAS Number	123683-33-0 ;
PubChem CID	9918881;
ChemSpider	8094523 ;
ChEMBL	CHEMBL436129 ;
(what is this?) (verify)

　　[★]

英: piperacillin-tazobactam
商: ゾシン Zosyn
関: piperacillin-tazobactam、ピペラシリン piperacillin タゾバクタム tazobactam

参考

http://www.weblio.jp/content/%E3%83%94%E3%83%9A%E3%83%A9%E3%82%B7%E3%83%AA%E3%83%B3%E2%80%90%E3%82%BF%E3%82%BE%E3%83%90%E3%82%AF%E3%82%BF%E3%83%A0 http://www.labo-tech.co.jp/iyakuhin/koukinyaku_binran/num09/nm09_06.html

[AHFS2017-1] ^ ^a ^b ^c ^d ^e ^f ^g ^h "Piperacillin Sodium and Tazobactam Sodium". The American Society of Health-System Pharmacists. Retrieved 8 December 2017.

[BNF69-2] British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 373. ISBN 9780857111562.

[3] "Piperacillin / tazobactam (Zosyn) Use During Pregnancy". Drugs.com. Retrieved 10 December 2017.

[WHO20th-4] "WHO Model List of Essential Medicines (20th List)" (PDF). World Health Organization. March 2017. Retrieved 29 June 2017.

[5] "Single Drug Information". International Medical Products Price Guide. Retrieved 10 December 2017.

[6] "Neutropenic Sepsis: Prevention and Management of Neutropenic Sepsis in Cancer Patients - National Library of Medicine - PubMed Health".

[7] "Piperacillin and Tazobactam Sodium". Merck Manual Professional. Archived from the original on November 20, 2010.

[8] Rousan TA, Aldoss IT, Cowley BD Jr, Curtis BR, Bougie DW, Aster RH, George JN (January 2010). "Recurrent acute thrombocytopenia in the hospitalized patient: Sepsis, DIC, HIT, or antibiotic-induced thrombocytopenia". 85 (1): 71–74. doi:10.1002/ajh.21536. PMC 4410979 . PMID 19802882.

[Drug_Shortages_›_Piperacillin_Tazobactam_Injection-9] "Drug Shortages › Piperacillin Tazobactam Injection". Drugs.com. 10 July 2017. Retrieved 12 July 2017.

[Major_shortage_forces_doctors_to_ration_important_antibiotic-10] "Major shortage forces doctors to ration important antibiotic". RT.com. 1 July 2017. Retrieved 12 July 2017.

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案内

Zosyn