Piperacillin

Piperacillin In Dogs & Cats: Uses, Dosage and Side Effects

Overview

• A time-dependent beta-lactam antibiotic that functions by binding to penicillin-binding proteins crucial for cell wall synthesis in bacteria.
• This action results in a reduction of bacterial cell wall strength and rigidity, impacting cell division, growth, and septum formation.
• Notably, the safety of beta-lactam antibiotics is attributed to the absence of a cell wall in animal cells.

Uses of Piperacillin

• Piperacillin, classified as a ureidopenicillin and grouped with ticarcillin as an antipseudomonal penicillin, is reserved for severe infections such as endocarditis or septicaemia.
• Its use is based on culture and sensitivity testing predicting a clinical response.
• Effective against Pseudomonas aeruginosa, Bacteroides fragilis, and other Gram-negative bacilli, particularly in neutropenic patients.
• For pseudomonal septicaemias, antipseudomonal penicillins are often administered with an aminoglycoside like gentamicin for a synergistic effect.
• Piperacillin is typically combined with a beta-lactamase inhibitor, and co-formulated with tazobactam.
• Limited experience exists in veterinary species, especially cats, and dosing is primarily empirical.
• Notably, piperacillin inhibits the excretion of the tazobactam component in dogs.

Dose of Piperacillin in Dogs and Cats

Dogs:

• Very little information is available to guide dosing.
• The human paediatric recommended dose is 80–100 mg/kg by slow i.v. injection/infusion q8h which could be used as a guide; 25–50 mg/ kg i.v. q4–6h.

Cats:

• No information is available.

Side Effects of Piperacillin in Dogs and Cats

• Nausea, diarrhoea and skin rashes are the most common adverse effects in humans.
• Painful if given by i.m. injection.
• The sodium content of each formulation may be clinically important for patients with restricted sodium intakes.

Contraindications of Piperacillin in Dogs and Cats

• No information available.

Some Notes:

• Piperacillin enhances the effects of non-depolarizing muscle relaxants.
• Gentamicin inactivates piperacillin if mixed in the same syringe.
• Clinical experience with this drug is limited.
• There is synergism between the beta-lactams and the aminoglycosides.