Tazocin Special Precautions

While Tazocin possesses the characteristic low toxicity of the penicillin group of antibiotics, periodic assessment of organ system functions including renal, hepatic and haematopoietic during prolonged therapy is advisable.
Bleeding manifestations have occurred in some patients receiving β-lactam antibiotics. These reactions have sometimes been associated with abnormalities of coagulation tests eg, clotting time, platelet aggregation and prothrombin time and are more likely to occur in patients with renal failure. If bleeding manifestations occur, the antibiotic should be discontinued and appropriate therapy instituted.
During prolonged therapy, leukopenia and neutropenia may occur; therefore, periodic assessment of hematopoietic function should be performed.
In case of severe, persistent diarrhoea, the possibility of antibiotic-induced, life-threatening pseudomembranous colitis must be taken into consideration. Therefore, Tazocin must be discontinued immediately in such cases and suitable therapy be initiated (eg, oral metronidazole or oral vancomycin). Preparations which inhibit peristalsis are contraindicated.
As with other antibiotics, the possibility of emergence of resistant organisms, which might cause superinfections, should be kept in mind particularly during prolonged treatment. Microbiological follow-up may be required to detect any important superinfection. If this occurs, appropriate measures should be taken.
Tazocin contains 2.79 mEq (64 mg) of sodium per gram of piperacillin which may increase a patient's overall sodium intake. Hypokalemia may occur in patients with low potassium reserves or who are receiving concomitant medications that may lower potassium levels; periodic electrolyte determinations may be advisable in such patients. Modest elevation of indices of liver function may be observed.
Antimicrobials used in high doses for short periods to treat gonorrhoea may mask or delay the symptoms of incubating syphilis. Therefore, prior to treatment, patients with gonorrhea should also be evaluated for syphilis. Specimens for darkfield examination should be obtained from patients with any suspected primary lesion, and serologic tests should be made for a minimum of 4 months.
Use in Patients with Hepatic Impairment: No dosage adjustment of Tazocin is necessary.
Use in Patients with Renal Impairment: In patients with renal insufficiency or hemodialysis patients, the IV dose should be adjusted to the degree of renal function impairment.
Use in Pregnancy: Studies in mice and rats have not demonstrated any embryotoxic or teratogenic effects of the piperacillin-tazobactam combination. There are no adequate and well-controlled studies with the piperacillin-tazobactam combination or with piperacillin or tazobactam alone in pregnant women. Piperacillin and tazobactam cross the placenta. Pregnant women should be treated only if the expected benefit outweighs the possible risks to the pregnant woman and fetus.
Use in Lactation: Piperacillin is excreted in low concentrations in human milk; tazobactam concentrations in human milk have not been studied. Women who are breastfeeding should be treated only if the expected benefit outweighs the possible risks to the woman and child.