Tazar

The drug Tazar is a combined penicillin-containing medication belonging to β-lactam antibiotics.

Indications Tazar

Tazar is used in therapeutic regimens for common or localized infections caused by gram (+) or gram (-) aerobic or anaerobic microorganisms that exhibit sensitivity to the drug.

 Adult patients Tazar can be prescribed:

• with infectious diseases of the respiratory system;
• with complicated or uncomplicated infectious processes in the urinary system;
• with infectious lesions of the skin and underlying tissues;
• with infections of internal organs;
• with bacterial sepsis;

At febrile states, proceeding against a background of neutropenia, in a combination with preparations-aminoglycosides.

 In children's practice, Tazar is used:

• for the relief of fever, developing against a background of neutropenia, in combination with aminoglycosides;
• with infection of internal organs, in particular in complications of acute appendicitis (peritonitis, abscessed infiltrate);
• with mixed infectious processes caused by microorganisms that are sensitive to the effects of the drug.

[1],

Release form

Tazar is a powdery substance of white color, which is used to prepare an injection solution.

Active ingredients of the medicament are piperacilin and tazobactam.

A cardboard box contains one bottle with a powdered preparation.

[2]

Pharmacodynamics

One of the main ingredients of the drug, piperacilin, is a representative of semisynthetic penicillins with a wide range of antibacterial activity that suppresses the development of bacteria by inhibiting the formation of the cell membrane and the development of the cell wall.

The second of the two main ingredients, tazobactam, is an inhibitor of β-lactamases, including enzymes that establish resistance to penicillin and cephalosporin medicines. Tazobactam has less antibacterial activity, but in combination with piperacillin significantly enhances the antibacterial action of the latter.

 Tazar affects the following groups of microorganisms:

• breivibacterium, corynebacterium;
• enterococci, lactococci;
• Listeria, propionobacteria, staphylococci;
• streptococci;
• acinetobacteria, cytrobacteria;
• enterobacteria, escherichia;
• Klebsiella, Morganella, Proteus;
• pseudomonas, salmonella, shigella;
• bifidobacteria, clostridia, eubacteria;
• peptococci, peptostreptococci;
• Bacteroides, fusobacteria, porphyromonas;
• legionnella and others.

[3]

Pharmacokinetics

The kinetic properties of the Tazar antibiotic are not fully investigated.

It is known that up to 30% of active ingredients of the drug bind to plasma proteins. The drug penetrates well into the cerebrospinal fluid and tissues in the body:

• in the lungs;
• in the organs of the female reproductive system;
• in the prostate;
• in the liver and bile ducts;
• in the bone tissue;
• into the intracellular fluid.

The average level of medication in the tissues can be from 50 to 100% of its level in the plasma fluid.

In the cerebrospinal fluid, the drug penetrates poorly.

The half-life can be 0.7-1.2 hours. Excretion from the body occurs with urinary fluid.

[4], [5], [6], [7], [8]

Dosing and administration

The tazar is administered by a dropwise injection lasting 30 minutes. The scheme of treatment implies the administration of 4.5 g of the drug approximately every 7 hours.

The usual daily dosage Tazar - 12 g, the limit - 16 g.

The duration of the therapeutic course is from 5 to 10 days (in the treatment of intragospital pneumonia - up to 2 weeks).

For patients who are on hemodialysis, a drug in the amount of 2.25 g is administered at the end of each hemodialysis session (with an average of 40% of the injected Tazar medication in a 4-hour procedure).

In pediatrics with appendicitis or peritonitis, Tazar is used every 8 hours in the amount of 112.5 mg per kilogram of the child's weight.

If there is a violation of kidney function in childhood, Tazar is not prescribed.

Instructions for the preparation of injection liquid:

• the powder from the vial is diluted in 20 ml of a dissolving substance (isotonic sodium chloride solution, dextrose solution, water for injection);
• the vial is not shaken, but slowly scrolled to dissolve the drug;
• the drug received is injected iv slowly, for half an hour.

Use Tazar during pregnancy

The kinetic properties of Tazar have not been studied enough, therefore, experts clearly do not advise using this medication during pregnancy.

It is proven that the drug enters the breast milk, which makes Tazar undesirable for appointment in the lactation period. In extreme circumstances, during the treatment with the drug, breastfeeding is suspended.

Without prescribing a doctor, you can not use the drug Tazar categorically.

Contraindications

Medicine Tazar should not be used:

• with excessive sensitivity of the patient to drugs penicillin or cephalosporin series, as well as to other drugs-inhibitors of β-lactam antibiotics;
• children up to 2 years of age;
• pregnant and lactating patients.

Relative contraindications are:

• internal and external bleeding;
• enterocolitis;
• chronic kidney disease;
• cystic fibrosis;
• hemodialysis and anticoagulant therapy.

[9], [10]

Side effects Tazar

• Dyspepsia, dry mouth, abdominal pain, jaundice, cholestasis.
• Rashes, fever, chills, allergic manifestations, runny nose, inflammation of the conjunctiva.
• Anemia, leukopenia, increased level of creatinine, thrombocytopenia, lengthening prothrombin index, neutropenia, thrombocytosis.
• Hypotension, rapid or slow heart rate, heart rhythm disturbance, cardiac failure, chest pain, heart attack.
• Pain in the head, dizziness, sleep disturbances, development of depressive and hallucinogenic conditions, trembling in the limbs, joint and muscle pain, general weakness, pain in the spine, convulsions.
• Local manifestations in the form of pain and redness at the injection site.
• Disorders of renal function, thrush, bleeding gums, stomatitis.
• The phenomena of bronchospasm, pulmonary edema, inflammation of the pharynx, choking in the throat.
• Anuria, dysuria, oliguria, blood in the urine, enuresis.
• Signs of hypoglycemia.
• Hemorrhages on the skin, bleeding of the nasal mucosa.
• Violations of consciousness.

[11], [12], [13]

Overdose

The clinical symptoms of overdose can be expressed as a condition of neuromuscular overexcitation, the appearance of seizures.

Treatment for overdose include taking medications depending on the symptoms:

• anticonvulsant medications (barbiturates, diazepam);
• hemodialysis, or peritoneal dialysis.

[14]

Interactions with other drugs

The combination of Tazar with such drugs as heparin, anticoagulants, as well as with other medications that affect hemostasis, requires constant monitoring of the degree of blood coagulation.

There is no compatibility between Tazar and sodium bicarbonate, as well as aminoglycosides in one injection. Such incompatibility is enjoyed by:

• Ringer's solution with lactate;
• blood and blood substitutes;
• albumin hydrolysates.

Complex treatment with probenecid lengthens the half-life of the main components of Tazar.

Combination Tazar and vecuronium extend neuromuscular blockade.

Tazar inhibits the excretion of methotrexate by the body.

Tazar does not affect the kinetic properties of tobramycin regardless of the function of the kidneys.

[15], [16]

Storage conditions

The bottles with Tazar powder are kept in dry darkened premises, in factory packages, at t ° no more than + 25 ° C. Places for storage of medicinal products should be located in places difficult for children.

[17]

Shelf life

Tazar can be kept for up to 3 years.