Β-Lactam Overview Along with Mezlocillin and Azlocillin

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Piperacillin* Class: β-lactam Overview Along with mezlocillin and azlocillin, piperacillin is a ureidopenicillin developed for additional activity against Klebsiella and Enterobacter species, and Pseudomonas aeruginosa. The drug is a derivative of ampicillin, an acyl side chain along with a piperazine group is added to the original molecule, and has similar activity against streptococcal species. Piperacillin is poorly absorbed because it is hydrolyzed by acids in the stomach. Carboxypenicillins, another pencillin group with enhanced activity against Pseudomonas aeruginosa and ureidopenicillins can precipitate the side effects of hypokalemia and hypernatremia, although side effects are generally less common with the latter. Piperacillin also acts through interference with cell wall synthesis. Resistance Some Pseudomonas aeruginosa strains have developed resistance to piperacillin by plasmid or chromosomal transfer of the ability to produce effective β-lactamases. Effectiveness Piperacillin and, in general, the ureidopenicillins are utilized primarily against Pseudomonas infections of the urinary tract, lung and blood. The drug also is very effective against Enterococcus species. In addition the ureidopenicillins exhibit enhanced activity against other aerobic Gram-negative organisms. Piperacillin specifically is used in infections caused by several Shigella and Proteus species and a few Citrobacter and Enterobacter species. This antimicrobial is also commonly used in the treatment of burn patients. Piperacillin is often combined with tazobactam, a β-lactamase inhibitor, to combat the production of β-lactamases by Gram-negative bacteria. *References available by request. Call the Infectious Disease Epidemiology Section, Office of Public Health, Louisiana Department of Health and Hospitals (504-219-4563) .

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28912 Oxoid FDA Cartridge Tables:1
* Adapted in part from CLSI document M100-S23 (M02-A11) : “Disc diffusion supplemental tablesʼʼ Performance standards for antimicrobial susceptibility testing. The complete standard may be obtained from the Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 1400, Wayne, PA 19807. Test Cultures (zone diameters in mm) Antimicrobial Agent Disc Code Potency Resistant Intermediate Susceptible Amikacin AK 30 μg EnterobacteriaceaeK, P. aeruginosa, Acinetobacter spp., and Staphylococcus spp. ≤14 15-16 ≥17 Amoxycillin - Clavulanic Acid AMC 20/10 μg EnterobacteriaceaeE ≤13 14-17 ≥18 Staphylococcus spp.A,Q ≤19 — ≥20 Haemophilus spp.A,Y ≤19 — ≥20 AmpicillinC,n AMP 10 μg EnterobacteriaceaeE and Vibrio choleraef ≤13 14-16 ≥17 Staphylococcus spp.A,Q ≤28 — ≥29 Enterococcus spp.A,V,W,k,m ≤16 — ≥17 Haemophilus spp.Y ≤18 19-21 ≥22 Streptococcus spp. ß-Hemolytic GroupA,d — — ≥24 Ampicillin – Sulbactam SAM 10/10 μg EnterobacteriaceaeE, Acinetobacter spp., and Staphylococcus spp. ≤11 12-14 ≥15 Haemophilus spp.A,Y ≤19 — ≥20 Azithromycin AZM 15 μg Staphylococcus spp., Streptococcus spp Viridans Groupn, ß-Hemolytic Group, and S. pneumoniae) ≤13 14-17 ≥18 Neisseria meningitidisA,i — — ≥20 Haemophilus spp.A — — ≥12 Aztreonam ATM 30 μg EnterobacteriaceaeE ≤17 18-20 ≤21 P. aeruginosa ≤15 16-21 ≥22 Haemophilus spp.A — — ≥26 CAR 100 μg Carbenicillin Enterobacteriaceae ≤19 20-22 ≥23 Pseudomonas aeruginosaP ≤13 14-16 ≥17 CEC 30 μg Cefaclor Enterobacteriaceae and Staphylococcus spp. ≤14 15-17 ≥18 Haemophilus spp.Y ≤16 17-19 ≥20 MA 30 μg Cefamandole EnterobacteriaceaeD,E and Staphylococcus spp. ≤14 15-17 ≥18 CefazolinG KZ 30 μg Staphylococcus spp.
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Vol. 13(26), pp. 407-413, August, 2019 DOI: 10.5897/AJMR2019.9084 Article Number: E3F64FA61643 ISSN: 1996-0808 Copyright ©2019 Author(s) retain the copyright of this article African Journal of Microbiology Research http://www.academicjournals.org/AJMR Full Length Research Paper Prevalence of urinary tract infection and antibiotic resistance pattern in pregnant women, Najran region, Saudi Arabia Ali Mohamed Alshabi1*, Majed Saeed Alshahrani2, Saad Ahmed Alkahtani1 and Mohammad Shabib Akhtar1 1Department of Clinical Pharmacy, College of Pharmacy, Najran University, Najran, Saudi Arabia. 2Department of Obstetics and Gyneocology, Faculty of Medicine, Najran University, Najran, Saudi Arabia. Received 25 February, 2019; Accepted August 5, 2019 Urinary Tract Infection (UTI) is one of the commonest infectious disease in pregnancy, and in pregnancy we have very limited number of antibiotics to treat the UTI. This study was conducted on 151 patients who attended the gynecology clinic during the study period. Nineteen UTI proven cases of UTI were studied for prevalence of microorganism and sensitivity pattern against different antibiotics. Among the bacteria isolated, Escherichia coli (73.68%) and Staphylococcus aureus (10.52%) were the most prevalent Gram negative and Gram positive bacteria respectively. To know the resistance pattern of microorganism we used commercially available discs of different antibiotics. Gram negative bacteria showed more resistance as compared to Gram positive one. It is observed that the most effective antibiotic for Gram negative isolates is Ceftriaxone (87.5%), followed by Amoxicillin + Clavulanic acid (81.25%), Amikacin (75%), Cefuroxime (75%), Cefixime (68.75%) and Mezlocillin (62.5%). For the Gram positive bacteria, Ceftriaxone, Amikacin and Amoxicillin + Clavulanic acid were the most effective antimicrobials (100%).
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Allergy Asthma Immunol Res. 2021 Mar;13(2):284-294 https://doi.org/10.4168/aair.2021.13.2.284 pISSN 2092-7355·eISSN 2092-7363 Original Article Piperacillin-Tazobactam Allergies: An Exception to Usual Penicillin Allergy Jane CY Wong ,1 Elaine YL Au ,2 Heather HF Yeung ,2 Chak-Sing Lau ,1 Philip Hei Li 1* 1Division of Rheumatology and Clinical Immunology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong 2Division of Clinical Immunology, Department of Pathology, The University of Hong Kong, Queen Mary Hospital, Hong Kong Received: Apr 21, 2020 Revised: Jul 20, 2020 ABSTRACT Accepted: Jul 26, 2020 Purpose: The majority of penicillin allergy labels are false, and skin tests (ST) have high Correspondence to negative predictive value (NPV) of up to 90%. Piperacillin-tazobactam (PT) allergy has been Philip Hei Li, MBBS, FHKCP suspected to be an exception to this, but existing literature is scarce. We investigate the Division of Rheumatology & Clinical Immunology, Department of Medicine, The epidemiology, clinical characteristics, testing outcomes and predictive value of ST in patients University of Hong Kong, Queen Mary Hospital, referred for suspected PT allergies. 102 Pokfulam Road, Hong Kong. Methods: The records of all patients referred for suspected PT allergy testing and Tel: +852-2255-3348 prescription rates of PT in all Hong Kong public hospitals (2015–2019) were analyzed. Fax: +852-2816-2863 Results: There was an increase in both PT prescriptions and number of newly reported E-mail: [email protected] PT allergies between 2015 and 2019. The majority (91.1%) of patients with suspected PT Copyright © 2021 The Korean Academy of allergy had at least 1 underlying medical co-morbidity or immunosuppressant use leading to Asthma, Allergy and Clinical Immunology • increased risk of infections.
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