Piperacillin is indicated for the following infections-

• Intra-abdominal infections
• Skin infections
• Pneumonia (Community acquired/ Nosocomial)
• Female pelvic infections

Abdominal Infection

Skin Infection

Pneumonia

Female pelvic invections

• The usual dose of piperacillin is 4 gram every 6-8 hours for adults & adolescents. 
• For patients with creatinine clearance of 20-40 mL/min, the recommended dose is 4 gram every 8 hours and for patients with creatinine clearance <20 mL/min is 4g every 12 hours.
• For pediatric patients the dose can vary from 80-100 mg/kg every 8 or 10 hours depending upon the type of infection.

The common side effects are-

• Rash
• Pruritus
• Nausea
• Vomiting
• Diarrhea

Rash

Nausea

Diarrhea

Insomnia (Difficulty in Falling asleep)

• Serious hypersensitivity reactions (anaphylactic/anaphylactoid) reactions have been reported in patients receiving Piperacillin.
• Severe skin disorders like Steven Johnson's syndrome and toxic epidermal necrolysis have also been reported.
• Hematological side effects have been reported, including hemorrhage, leukopenia, and neutropenia. During long-term treatment, keep an eye on your hematologic tests.
• In hemodialysis patients, piperacillin treatment can considerably lower tobramycin concentrations. In these patients, keep an eye on their tobramycin levels.
• Co-administration of piperacillin with vancomycin may increase the incidence of acute kidney injury. Monitor kidney function in patients receiving piperacillin and vancomycin.
• The neuromuscular blockade of vecuronium and other non-depolarizing muscle relaxants may be prolonged by piperacillin.