Adult

Piperacillin-Tazobactam

General Information

Anti-pseudomonal penicillin and beta-lactamase inhibitor. Do NOT use if patient is allergic to penicillin.

For adult critical care areas only: Where using piperacillin-tazobactam by continuous infusion see Adult Intensive Care Medication Guidelines

 

Restricted formulary antimicrobial: For details see OUH netFormulary

AWaRe antibiotic classification: 'Watch'. Use as per guidelines. All other indications to be discussed with Micro/ID.

For all information regarding contra-indications, interactions, contraception, pregnancy and breastfeeding and additional information, see BNF and Summary of Product Characteristics (SPC).

Dosing

 

Intravenous piperacillin-tazobactam

Standard dose

4.5g TDS

Pseudomonas or neutropenic sepsis

4.5g QDS

or

4.5g TDS extended infusion (over 4 hours)

Note for extended infusions: 4.5g stat (first dose) should be given as soon as possible THEN 4.5g TDS, infuse each dose over 4 hours (six hours after the initial stat dose)

Elastomeric device

4.5g stat (first dose) should be given THEN 13.5g over 24hrs

Obesity

Consider 4.5g QDS in obese patients, depending on renal function.

Where using TDS dosing then administer dose as an extended infusion over 4 hours.

Renal and hepatic impairment

Renal Impairment

eGFR (mL/min/1.73m2)

piperacillin-tazobactam dose

More than 40

Dose as in normal renal function

20-40

Max 4.5g TDS

Less than 20

Max 4.5g BD

HD/HDF/High Flux

Dialysed; give post-dialysis on dialysis days.

Dose as in eGFR less than 20 mL/min/1.73m2

PD

Not dialysed.

Dose as in eGFR less than 20 mL/min/1.73m2

 

Hepatic impairment

No dose adjustment required.

References

  • Bowmed Ibisqus Limited. Piperacillin 4g / Tazobactam 500mg powder for solution for infusion vials summary of product characteristics. Electronic medicines compendium. Last revision of the text 1/6/22. Accessed via www.medicines.org.uk Accessed 02/11/26.
  • British National Formulary. Piperacillin with tazobactam. BNF online accessed via www.medicinescomplete.com Accessed 02/11/26.
  • The Renal Drug Database. Tazocin (Piperacillin/tazobactam). Last updated 10/4/26. Accessed via https://renaldrugdatabase.com Accessed 02/11/26.
  • Sanford Guide [online]. Piperacillin-tazobactam. Last updated 30/10/26. Accessed via https://webedition.sanfordguide.com. Accessed 02/11/26.
  • GIG Cymru NHS Wales. All Wales antimicrobial dosing in extremes of body weight in adults. Last updated April 2022. Accessed via https://phw.nhs.wales/resources/all-wales-antimicrobial-dosing-in-extremes-of-body-weight-in-adults/ Accessed 02/11/26
  • Meng L, Mui E, Ha DR, Stave C, Deresinski SC, Holubar M. Comprehensive guidance for antibiotic dosing in obese adults: 2022 update. Pharmacotherapy. 2023; 43(3):226-46

Editorial Information

Last reviewed: 02 Nov 2026

Next review date: 05 Nov 2029

Author(s): AMST.