PIPERACILLIN

Piperacillin belongs to the ureidopenicillin class of broad-spectrum β-lactam antibiotics. Piperacillin has a polar side chain that enhances penetration into gram-negative bacteria and reduces susceptibility to cleavage by gram-negative beta-lactamase enzymes. Piperacillin is sometimes also referred to as an "anti-pseudomonal penicillin" because of its activity against the important hospital pathogen Pseudomonas aeruginosa. By itself, It has weak activity against the gram-positive pathogens like Staphylococcus aureus, as the beta-lactam ring gets hydrolyzed by the bacteria's beta-lactamase. Piperacillin is used most often in combination with Tazobactam, a beta-lactamase inhibitor. The combination enhances Piperacillin's effectiveness by reducing its susceptibility by inhibiting several beta-lactamases.  Toyama Chemical Co Ltd patented Piperacillin in 1974. In the USA the patent was filed by American Cyanamid Company and approved for medical use in 1981. Due to its efficacy and safety, it features on the list of medicines ‘critically important for human medicine’ by the World Health Organization. Piperacillin is sold as Piperacillin/Tazobactam 4 g/0.5 g Powder for Solution for Infusion, where 1 vial has 4 g piperacillin as sodium salt and 0.5 g tazobactam as the sodium salt. The usual recommended adult dose is 4 g piperacillin / 0.5 g tazobactam administered every eight hours. While treating nosocomial pneumonia and bacterial infections in neutropenic patients, the usual recommended adult dose is 4 g piperacillin / 0.5 g tazobactam administered every six hours. For children under 2 years of age, the dose is 80 mg Piperacillin / 10 mg Tazobactam per kilo of body weight given every six hours for treating Neutropenic children with fever from bacterial infections. For treating Complicated intra-abdominal infections, the recommended dose is 100 mg Piperacillin / 12.5 mg Tazobactam per kilo of body weight given every eight hours.

The price of Piperacillin 

In the USA, depending on the pharmacy and brands, for a supply of 10 powder for injection, the consumers have to pay between $69.30 and $138.60. the same supply of 10 powder for injection will cost around USD60 in India.

How does it work?

Piperacillin exerts bactericidal action by inhibiting bacterial cell wall synthesis. It does this by binding one or more of the penicillin-binding proteins (PBPs).  It actions cause bacterial autolytic effect by inhibiting PBPs responsible for activation of bacterial autolytic process. After binding, it stops the third and last stage of bacterial cell wall synthesis. Post which the bacterial cell wall autolytic enzymes like autolysins can mediate cell lysis.

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