Tazpen Dosage/Direction for Use

Dosage: Neutropenic patients with signs of infection (e.g. fever) should receive immediate empirical antibiotic therapy before laboratory results are available.
Adults and children 12 years and older with Normal Renal Function: Usual dose: 4.5 g given every eight hours. The total daily dose depends on the severity and localization of the infection and can vary from 2.25 g to 4.5 g administered every six or eight hours.
Neutropenia: Recommended dose: 4.5 g given every six hours in combination with an aminoglycoside.
Children under the age of 12 years: Recommended only for the treatment of children with neutropenia. TAZPEN should not be used in children who do not have neutropenia.
Children weighing more than 50 kg: Follow adult dosing guidance, including the aminoglycoside.
Children with Normal Renal Function and weighing less than 50 kg: Adjust dose to 90 mg/kg (80 mg piperacillin/10 mg tazobactam) given every 6 hours in combination with an aminoglycoside.
Hospitalized children with intra-abdominal infection: For children aged 2 to 12 years, weighing up to 40kg, and with normal renal function, the recommended dosage is 112.5 mg/kg (100 mg piperacillin/12.5 mg tazobactam) every 8 hours.
For children aged 2 to 12 years, weighing over 40 kg, and normal renal function, follow the adult dose guidance, i.e. 4.5 g (4 g piperacillin/0.5 g tazobactam) every 8 hours. The duration of therapy should be guided by the severity of the infection and the patient's clinical and bacteriological progress.
Elderly: Recommended dose the same as adults except in cases of renal impairment.
Renal insufficiency: Adults and Children weighing more than 50 kg: The intravenous dose should be adjusted to the degree of actual renal function impairment. The suggested daily doses are as follows in Table 1: See Table 1.

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For patients on haemodialysis, the maximum daily dose is 8 g/1 g/day Piperacillin and Tazobactam. In addition, because haemodialysis removes 30%-50% of piperacillin in 4 hours, one additional dose of 2 g piperacillin/0.25 g tazobactam should be administered following each dialysis period. For patients with renal failure and hepatic insufficiency, measurement of serum levels of TAZPEN will provide additional guidance for adjusting dosage.
Children weighing less than 50 kg: The intravenous dosage should be adjusted to the degree of actual renal impairment as in Table 2: See Table 2.

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Children weighing less than 50 kg on haemodialysis: Recommended dose is 45 mg/kg every 8 hours. The pharmacokinetics of piperacillin and tazobactam have not been studied in paediatric patients with renal impairment. Each patient must be monitored closely for signs of drug toxicity. Drug dose and interval dose should be adjusted accordingly. In patients with renal insufficiency or hemodialysis patients, intravenous dosages and administration intervals should be adjusted to the degree of renal function impairment.
Duration of therapy: Therapy is recommended to be a minimum of 5 days and maximum of 14 days, considering that dose administration should continue at least 48 hours after the resolution of clinical signs and symptoms or fever.
Administration: TAZPEN may be given by slow intravenous injection (3-5 minutes) or by infusion (20-30 minutes).
Directions for Reconstitution and Dilution: Diluents for reconstitution: Sterile water for injection; Sodium chloride injection; Bacteriostatic Water/Benzyl Alcohol; Bacteriostatic Saline/Benzyl Alcohol; Bacteriostatic Water/Parabens; Bacteriostatic Saline/Parabens.
IV injection: Reconstitute each vial with the volume of diluent shown in the table as follows, using one of the previously mentioned diluents. Shake until dissolved. (See Table 3.)

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IV infusion: Reconstitute each vial with at least 20 mL using one of the reconstitution diluents previously mentioned. Shake until dissolved. The reconstituted solution may be further diluted (recommended volume per dose of 50-150 mL) with a compatible IV solution listed as follows: 0.9% Sodium Chloride for Injection; Sterile Water for Injection*; Dextrose 5%; Dextran 6% in Saline.
Administer by infusion over a period of at least 30 min. During the infusion, it is desirable to discontinue the primary infusion solution.
Note:* Maximum recommended volume per dose of Sterile Water for Injection is 50 mL.