Parenteral Manual


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Alternate Name(s): 
Antibiotic with B-lactamase inhibitor
Original Date: 
August 2005
Revised Date: 
January 2021
  • Treatment of infections caused by susceptible bacteria including beta-lactamase producing strains
Reconstitution and Stability: 




2 g P/0.25 g T

18.4 mL

100 mg/mL P/12.5 mg/mL T

3 g P/0.375 g T

27.6 mL

100 mg/mL P/12.5 mg/mL T

4 g P/0.5 g T 36.8 mL 100 mg/mL P/12.5 mg/mL T
12 g P/1.5 g T 102 mL 100 mg/mL P/12.5 mg/mL T
  • Store vials at room temperature
  • Shake well until dissolved
  • Reconstituted vial stable 24 hours at room temperature and 48 hours refrigerated
  • Diluted solutions stable 24 hours at room temperature and 7 days refrigerated

- Solutions Compatible: D5W, 0.9% NaCl, ringer's lactate

- Additive/Above Cassette Compatible: no information

- Y-site Compatible: clindamycin, dopamine, fluconazole, hydromorphone, magnesium sulfate, metoclopramide, metronidazole, morphine, KCl, ondansetron, sodium bicarbonate, TPN (amino acids/dextrose)

- Incompatible: acyclovir, amiodarone, amphotericin B, azithromycin, chlorpromazine, dobutamine, doxycycline, droperidol, ganciclovir, haloperidol, hydroxyzine, prochlorperazine, promethazine, administration of aminoglycosides and piperacillin/tazobactam should be separated by at least 30-60 minutes



(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Direct


IV Intermittent Infusion

Usual dilution: 100 mg/mL

- 20 mg/mL for dose less than 200 mg
Infusion time: Q4 - Q6H dosing over 30 minutes 
                          Q8H dosing over 4 hours

IV Continuous Infusion NO

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • Dosage recommendations are based on the piperacillin component


  • 300 mg IV of piperacillin component/kg/day divided Q6H
  • Maximum: 4 g/dose of piperacillin component (16 g/day of piperacillin component/day)


  • 3g - 4g of piperacillin component IV Q4 - 6 hours
  • Maximum 4 g/dose of piperacillin component (16 g/day of piperacillin component/day)
  • 3g of piperacillin component = 3.375g of piperacillin-tazobactam


  • CrCl 20-40 mL/minute: Decrease dose by 30% and administer Q6H
  • CrCl <20  mL/minute: Decrease dose by 30% and administer Q8H
Potential hazards of parenteral administration: 
  • Local reactions at injection site: pain, phlebitis, inflammation
  • Hypersensitivity reactions - manifested by rash, pruritus, bronchospasm, anaphylaxis
  • Hypokalemia
  • Increases in liver enzymes, leukopenia, platelet dysfunction, decrease in hemoglobin/hematocrit, prolonged prothrombin time, elevated BUN and creatinine
  • Diarrhea, nausea, vomiting
  • Neuromuscular excitability or convulsions with high doses especially in patients with renal insufficiency
  • If extravasation occurs, click HERE for treatment guidelines.   
  • Sodium content: 2.35 mmoL sodium per 1 g piperacillin
  • Monitor serum electrolytes, bleeding time (especially in patients with renal impairment); periodic tests of renal, hepatic and hematologic function
  • Cross sensitivity with other beta-lactam antibiotics may occur (penicillins, cephalosporins)
  • If piperacillin/tazobactam is prescribed Q8H, administer each dose over 4 hours (Clinical Infectious Disease 2007; 44:357-63)

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