Comparative Pharmacology
Head-to-head clinical analysis: PIPERACILLIN versus TOTACILLIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: PIPERACILLIN versus TOTACILLIN.
PIPERACILLIN vs TOTACILLIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), inhibiting transpeptidation, and activating autolytic enzymes.
Bactericidal: inhibits cell wall synthesis by binding to penicillin-binding proteins (PBPs), inhibiting transpeptidation. Active against gram-positive bacteria and some gram-negative bacteria.
3.375 g IV every 6 hours (piperacillin-tazobactam); for piperacillin alone, 3 g IV every 6 hours.
250-500 mg orally every 6 hours or 1-2 g intravenously every 4-6 hours.
None Documented
None Documented
0.6-1.2 hours in adults with normal renal function; prolonged to 2-6 hours in renal impairment (CrCl <20 mL/min); requires dose adjustment in renal failure
Clinical Note
moderatePiperacillin + Probenecid
"The serum concentration of Probenecid can be increased when it is combined with Piperacillin."
Clinical Note
moderatePiperacillin + Mycophenolic acid
"The serum concentration of the active metabolites of Mycophenolic acid can be reduced when Mycophenolic acid is used in combination with Piperacillin resulting in a loss in efficacy."
Clinical Note
moderatePiperacillin + Plicamycin
"The serum concentration of Plicamycin can be decreased when it is combined with Piperacillin."
Clinical Note
moderateTerminal elimination half-life: 1.0-1.5 hours in normal renal function. Extended to 2-6 hours in renal impairment; requires dose adjustment when CrCl <30 mL/min.
Renal: approximately 70-90% unchanged via glomerular filtration and tubular secretion; biliary: 10-20% excreted unchanged in bile; fecal: minor (<5%)
Renal: 90-95% unchanged via glomerular filtration and tubular secretion. Biliary/fecal: <5% as unchanged drug and metabolites.
Category C
Category C
Penicillin Antibiotic
Penicillin Antibiotic
Piperacillin + Valrubicin
"The serum concentration of Valrubicin can be decreased when it is combined with Piperacillin."