LIMERIK ® Piperacillin + Tazobactam

LIMERIK ® is a drug based on Piperacillin + Tazobactam

THERAPEUTIC GROUP: General antimicrobials for systemic use - association of penicillins and beta-lactamase inhibitors

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications LIMERIK ® Piperacillin + Tazobactam

LIMERIK ® is an antibiotic indicated for the treatment of infectious diseases of the respiratory, genito-urinary and integumentary systems supported by bacteria sensitive to piperacillin.

The wide spectrum of action and the excellent microbicidal activity allows LIMERIK ® to be used also in the treatment of infections sustained by particularly resistant Gram negative bacteria such as Pseudomonas and Klebsiella.

Mechanism of action LIMERIK ® Piperacillin + Tazobactam

LIMERIK ® is a broad-spectrum antibiotic widely used in the clinical setting for the treatment of infections caused by Gram negative bacteria.

Its main active ingredient, Piperacillin, is a semisynthetic penicillin belonging to the chemical class of ureidopenicilline characterized by a marked microbicidal activity directed towards Pseudomonas auriginosa.

This activity is supported by the ability of this antibiotic to block the transpeptidation reaction by preventing the structuring of the peptidoglycan through the various cross-linking and consequently making the beating particularly sensitive to osmotic variations so as to determine its own death due to osmotic shock.

Despite the high efficacy of piperacillin, numerous microorganisms have developed mechanisms of resistance to antibiotic therapy, characterized primarily by the production of enzymes known as beta lactamases capable of opening the beta lactam ring of the various active principles thus reducing their function.

For this reason, in order to preserve the microbicidal activity of piperacillin, tazobactam is also found in LIMERIK ®, a penicillin-derived molecule that covalently binds beta-lactamases, limiting its activity and therefore maintaining the antibiotic's high efficacy. .

Studies carried out and clinical efficacy

1.PIPERICILLIN / TAZOBACTAM IN THE TREATMENT OF KERATITES BY PSEUDOMONAS

J Ocul Pharmacol Ther. 2010 Apr; 26 (2): 219-22.

Interesting work that evaluates the effectiveness of topical treatment with piperacillin and tazobactam in Pseudomonas Auriginosa-associated keratitis. In these three cases the result was satisfactory enough to suggest the development of future studies.

2 . THE EFFECTIVENESS OF PIPERICILLIN / TAZOBACTAM IN THE TREATMENT OF SERIOUS PULMONITES

Pulm Pharmacol Ther. 2010 Oct; 23 (5): 403-10. Epub 2010 Jun 2.

Work demonstrating that the intake of tazobactam / piperacillin is effective and safe in the treatment of pneumonia, even serious ab ingestis or acquired in the community, allowing a remission of symptoms in a few days of treatment.

3.IPERSENSITIVITY DELAYED TO THE PIPERICILLINA-TAZOBACTAM

J Bone Joint Surg Br. 2010 Nov; 92 (11): 1596-9.

Case report denouncing the development of a delayed hypersensitivity reaction to piperaciilina / tazobactam following the use of a medicated prosthesis with antibiotic used in total knee replacement. The symptomatology characterized by fever, rash, pain and paresthesia in the absence of infection resulted to the pathognomonic quantum.

Method of use and dosage

LIMERIK ®

Powder and solvent for solution for injection for intramuscular use from 2 g of piperacciline and 250 mg of tazobactam for 4 ml of solution.

Treatment of bacterial infections with LIMERIK ® should be supervised by your doctor, who after assessing the health status of the patient and the severity of the clinical picture could define the correct dosage and the relative timing of recruitment.

Generally in adults, 2 g of piperacillin are administered every 12 hours, prolonging the treatment for at least 48 hours after the disappearance of the symptoms, in order to avoid possible remissions.

An adjustment of the dosages should also be envisaged for elderly patients or those suffering from kidney diseases, as well as for pediatric patients.

It should be remembered that the vial with solvent containing lidocaine should only be administered intramuscularly.

Warnings LIMERIK ® Piperacillin + Tazobactam

Treatment with LIMERIK ® should be supervised by your doctor and suggested when the cultural examination and antibiogram show the presence of sensitive piperacillin microorganisms.

The inappropriate use of piperacillin, as well as that of any other antibiotic, could indeed favor the development of multi-drug resistant microorganisms, insensitive to antibiotic therapy.

In order to reduce the incidence of clinically relevant side effects, the doctor should periodically assess the health status of the patient undergoing treatment, especially considering the state of liver and kidney function.

The appearance of persistent diarrhea, such as to require the possible integration of liquids and electrolytes, should alarm the doctor, fueling the suspicion of pseudomembranous colitis.

Intravenous or intravenous dosing of LIMERIK ® should be supervised by a healthcare professional.

PREGNANCY AND BREASTFEEDING

The use of LIMERIK ® in pregnancy should only take place in cases of real need and always under strict medical supervision.

The absence of studies able to characterize the safety profile of piperacillin when taken during pregnancy considerably limits the use of this medicine during the gestational period.

Intake of LIMERIK ® is also contraindicated during breastfeeding, given the ability of piperacillin to concentrate in breast milk.

Interactions

Patients on LIMERIK ® therapy should pay particular attention to the simultaneous intake of other active ingredients capable of varying the pharmacokinetic and pharmacodynamic properties of piperacillin, thus compromising both its therapeutic activity and its safety profile.

Among the active ingredients able to determine these reactions it is possible to remember the:

Vecuronium and muscle relaxants, whose therapeutic activity is generally enhanced by the concomitant intake of piperaciilina;
Allopurinol, due to the increased risk of allergic reactions;
Probenecid, responsible for the increase in blood concentrations and the hepatic and renal side effects of pipericillin;
Warfarin, due to the increased risk of bleeding;
Methotrexate, due to the high toxicity of the active ingredient.

Contraindications LIMERIK ® Piperacillin + Tazobactam

The use of LIMERIK ® is contraindicated in patients hypersensitive to penicillins and cephalosporins or their excipients and lidocaine.

Undesirable effects - Side effects

Piperaciilin therapy is generally well tolerated and free of particularly serious side effects.

In most cases redness, pain and swelling at the injection site as well as nausea, diarrhea and vomiting are the most frequently observed side effects.

Although rarely, leukopenia, neutropenia, thrombocytopenia and rarely anemia, headache, insomnia, hypotension, phlebitis, hypertransaminasemia, hyperbilirubinemia and fever may be added to the above symptoms.

However, the possible symptoms associated with the development of hypersensitivity reactions to the active ingredient potentially responsible for edema, angioedema, bronchospasm, laryngospasm, hypotension and anaphylactic shock in the most serious cases are of particular concern.