A Comprehensive Monograph on Piperacillin (DB00319): Pharmacology, Clinical Utility, and Safety Profile

Drug Identity and Physicochemical Properties

Introduction

Piperacillin is a semi-synthetic, fourth-generation, extended-spectrum ureidopenicillin antibiotic derived from ampicillin.[1] As a member of the β-lactam class of antimicrobials, it occupies a central role in the management of complex bacterial infections, particularly those encountered in the hospital setting. Its chemical structure, which incorporates a polar side chain, enhances its penetration into Gram-negative bacteria and confers a degree of stability against cleavage by certain Gram-negative β-lactamase enzymes.[4] This structural feature is responsible for its potent activity against the opportunistic pathogen

Pseudomonas aeruginosa, earning it the designation of an "anti-pseudomonal penicillin".[4]

In contemporary clinical practice, piperacillin is almost exclusively formulated and administered in a fixed-dose combination with tazobactam, a β-lactamase inhibitor.[4] The rationale for this combination is rooted in the global challenge of antimicrobial resistance. Many clinically significant bacteria have acquired the ability to produce β-lactamase enzymes, which hydrolyze and inactivate penicillin antibiotics, rendering them ineffective. Tazobactam serves as a "protector" molecule; it irreversibly binds to and inhibits many of these bacterial enzymes, thereby restoring and extending piperacillin's spectrum of activity.[7] This combination product, piperacillin/tazobactam, is a cornerstone of empiric therapy for serious, moderate-to-severe, and often polymicrobial infections, including intra-abdominal infections, hospital-acquired pneumonia, and febrile neutropenia.[4]

Chemical and Physical Data