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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