Mechanism of Action & Class
Piperacillin, one component of Zosyn, falls under this family of antibiotics.
Penicillin (β-lactam) antibiotics
Zosyn is commonly used to treat severe lung infections, including hospital-acquired ________.
Pneumonia
The most common gastrointestinal side effect of Zosyn is ________ (as with many antibiotics)
Diarrhea
Zosyn is mainly excreted by the kidneys. In patients with renal impairment, the dose must be adjusted (reduced) to prevent accumulation
Reduce the dosage for patients with poor kidney function
Zosyn is administered via this route (never given orally)
Intravenous (IV) infusion
Zosyn kills bacteria by inhibiting the synthesis of this critical structural component of the bacterial cell.
The bacterial cell wall (peptidoglycan).
Due to its anaerobic coverage, Zosyn is indicated for serious infections within this body cavity.
Intra-abdominal (stomach area) infections
Patients with penicillin allergy may develop this life-threatening reaction to Zosyn, characterized by rash, hives, and difficulty breathing.
Anaphylaxis (severe allergic reaction)
Each 4.5 g dose of Zosyn contains a substantial amount of sodium. Use caution in patients on a sodium-restricted diet (e.g. heart failure)
High dietary sodium – caution in salt-restricted patients
Before giving Zosyn, the nurse must verify if the patient has any history of allergy to ________.
Penicillins or other β-lactam antibiotics
Tazobactam enhances piperacillin’s efficacy by inhibiting these bacterial enzymes.
β-lactamase enzymes (which normally destroy penicillins).
Thanks to its broad spectrum (gram-positive, gram-negative, and anaerobes), Zosyn is often chosen for initial empiric therapy in life-threatening infections such as ________.
Septicemia (severe bloodstream infection/sepsis)
In cases of renal impairment or very high doses, Zosyn can accumulate and cause neurotoxic effects, including ________.
Seizures (convulsions)
Zosyn should NOT be mixed in the same IV line or syringe with aminoglycoside antibiotics (e.g. gentamicin) due to incompatibility that inactivates the aminoglycoside.
Incompatibility with aminoglycosides (administer separately)
Nurses should instruct patients to finish the entire prescribed course of Zosyn, even if they feel better, to ensure the infection is fully treated.
Complete the full antibiotic course as directed
The term “antipseudomonal penicillin” indicates that Zosyn is active against ________, a notoriously resistant Gram-negative bacterium.
Pseudomonas aeruginosa
Zosyn is often prescribed for this type of infection, frequently found in hyperglycemic patients, that may involve mixed aerobic and anaerobic pathogens and poses a risk of severe tissue damage if untreated.
Diabetic foot infections
Use of broad-spectrum antibiotics like Zosyn can lead to overgrowth of Clostridioides difficile, causing severe colitis with profuse ________.
Watery, bloody diarrhea (C. diff infection)
Piperacillin/tazobactam can enhance the effect of warfarin. Co-administration may increase the risk of bleeding (prolonged INR).
Increased bleeding tendency (enhanced anticoagulant effect)
Each dose of Zosyn is typically infused over approximately 30 minutes for safe administration
30 minutes per IV infusion
Penicillin antibiotics like piperacillin exert their effect by binding to these specific proteins on bacteria.
Penicillin-binding proteins (PBPs)
Despite its broad spectrum, Zosyn is not effective against this drug-resistant pathogen often implicated in hospital infections.
Methicillin-resistant Staphylococcus aureus (MRSA)
Prolonged therapy with Zosyn can occasionally suppress bone marrow. Notably, it may cause a drop in neutrophils, a condition called ________.
Neutropenia (low neutrophil count)
Concomitant use of Zosyn and vancomycin has been associated with a higher risk of nephrotoxicity, so kidney function should be closely monitored.
Kidney damage (acute nephrotoxicity)
Piperacillin/tazobactam may reduce the efficacy of hormonal birth control. Female patients should be advised to use a backup non-hormonal contraceptive during treatment.
An additional/alternative form of contraception (backup birth control)