INDICATIONS AND USAGE
Therapeutic: PIPRACIL is indicated for the treatment of serious infections caused
by susceptible strains of the designated microorganisms in the conditions
listed below:Intra-Abdominal
Infections including hepatobiliary and surgical infections
caused by E. coli, Pseudomonas aeruginosa, enterococci, Clostridium spp., anaerobic cocci, or Bacteroides spp., including B. fragilis.Urinary Tract Infections caused by E. coli, Klebsiella spp., P. aeruginosa, Proteus spp., including P. mirabilis, or enterococci.Gynecologic Infections including endometritis, pelvic inflammatory disease, pelvic cellulitis
caused by Bacteroides spp.,
including B. fragilis, anaerobic
cocci, Neisseria gonorrhoeae, or enterococci (E. faecalis). Septicemia including bacteremia caused by E. coli, Klebsiella
spp., Enterobacter spp., Serratia spp., P. mirabilis, S. pneumoniae, enterococci, P. aeruginosa, Bacteroides
spp., or anaerobic
cocci.Lower RespiratoryTract Infections caused by E. coli, Klebsiella spp., Enterobacter spp., P.aeruginosa, Serratia spp., H. influenzae, Bacteroides spp., or anaerobic cocci.
Although improvement has been noted in patients with cystic fibrosis,
lasting bacterial eradication may not necessarily be achieved.Skin and Skin Structure Infections caused by E. coli, Klebsiella spp., Serratia spp., Acinetobacter
spp., Enterobacter spp., P. aeruginosa, Morganella morganii, Providenciarettgeri, Proteus vulgaris, P. mirabilis, Bacteroides spp., including B. fragilis, anaerobic cocci, or enterococci.Bone and Joint Infections caused by P. aeruginosa, enterococci, Bacteroides spp., or anaerobic cocci.Uncomplicated Gonococcal Urethritis caused by N. gonorrhoeae.PIPRACIL has also been shown to be clinically effective for the treatment
of infections at various sites caused by Streptococcus species including S. pyogenes and S. pneumoniae; however, infections caused by these organisms are ordinarily treated
with more narrow spectrum penicillins. Because of its broad spectrum
of bactericidal activity against gram-positive and gram-negative aerobic
and anaerobic bacteria, PIPRACIL is particularly useful for the treatment
of mixed infections and presumptive therapy prior to the identification
of the causative organisms. Also, PIPRACIL
may be administered as single drug therapy in some situations where
normally two antibiotics might be employed.Piperacillin has been successfully used with aminoglycosides, especially
in patients with impaired host defenses. Both drugs should be used
in full therapeutic doses.Appropriate cultures
should be made for susceptibility testing before initiating therapy
and therapy adjusted, if appropriate, once the results are known.Prophylaxis: PIPRACIL
is indicated for prophylactic use in surgery including intra-abdominal
(gastrointestinal and biliary) procedures, vaginal hysterectomy, abdominal
hysterectomy, and cesarean section. Effective prophylactic use depends
on the time of administration; PIPRACIL should be given one-half to
one hour before the operation so that effective levels can be achieved
in the site prior to the procedure.The prophylactic use of piperacillin should be stopped within 24
hours, since continuing administration of any antibiotic increases
the possibility of adverse reactions, but in the majority of surgical
procedures, does not reduce the incidence of subsequent infections.
If there are signs of infection, specimens for culture and susceptibility
testing should be obtained for identification of the causative microorganism
so that appropriate therapy can be instituted.To reduce the development of drug-resistant bacteria and maintain
the effectiveness of PIPRACIL and other antibacterial drugs, PIPRACILshould only be used to treat or prevent infections that are proven
or strongly suspected to be caused by susceptible bacteria. When culture
and susceptibility information are available, they should be considered
in selecting or modifying antibacterial therapy. In the absence of
such data, local epidemiology and susceptibility patterns may contribute
to the empiric selection of therapy.