The antibiotic piperacillin belongs to the group of penicillins. It is used for the therapy of bacterial infections.
What is piperacillin?
The antibiotic piperacillin belongs to the group of penicillins. It is used for the therapy of bacterial infections. Piperacillin is an antibiotic that belongs to the group of penicillins. More precisely, it is acylaminopenicillin. In addition, piperacillin forms a beta-lactam antibiotic that has a four-membered lactam ring in its structural formula. Of all the penicillins, piperacillin has the best spectrum of activity. Penicillins such as piperacillin represent the oldest antibiotic agents used in medicine. In 1928, Scottish bacteriologist Alexander Fleming (1881-1955) discovered penicillin by accident. At the time, Fleming was working at St. Mary’s Hospital in London with Staphylococcus bacteria on a bacterial nutrient plate, which he temporarily left unattended. Upon his return, the scientist found a mold called Penicillium notatum growing on the agar plate. In contrast, bacterial growth was absent in the area surrounding the fungus. The active ingredient exhibited bactericidal properties and was given the name penicillin by Alexander Fleming. Particularly during the Second World War, penicillin developed its positive effect so that a large number of wound infections could be successfully treated. In modern times, however, many strains of bacteria are resistant to penicillin. Nevertheless, penicillins such as piperacillin are still used successfully. For example, piperacillin is effective for all infections caused by susceptible bacteria.
Pharmacologic action
Piperacillin is equipped with the typical mode of action of penicillin. Thus, the antibiotic inhibits the construction of the cell wall of bacteria, which leads to their death. The effect of piperacillin exceeds the properties of benzylpenicillin. Thus, there is a bactericidal effect against enterobacteria, anaerobes and gram-negative rods. However, there is also a poorer effect against gram-positive cocci than with benzylpenicillin. Nevertheless, the bactericidal effect of piperacillin is sufficient and can be compared with the effect of amoxicillin. Piperacillin can be destroyed by beta-lactamases, which are special bacterial enzymes. For this reason, medicine usually combines piperacillin with other bacteria-killing antibiotics that are also able to kill bacteria with enzymes of this type.
Medical application and use
The use of piperacillin is suitable for numerous bacterial infections that can take both an acute and a chronic course. These include conditions caused by gram-negative rods, such as cystitis (urinary bladder infection), urethritis (urethritis), or pyelonephritis (inflammation of the renal pelvis). Piperacillin is also effective in biliary tract infections, intra-abdominal abscesses, peritonitis, pneumonia in patients on artificial respiration, gynecological infections such as adnexitis or endometritis. Other indications include nosocomial infections caused by the bacterial species Pseudomonas aeruginosa, inflammation of the inner lining of the heart (endocarditis), severe sepsis (blood poisoning), joint and bone infections such as osteomyelitis (inflammation of the bone marrow), and infections of the skin and soft tissues after burns, accidents, or surgery. Piperacillin is used exclusively by infusion or injection. Oral administration in the form of a tablet is not suitable, as the drug does not have acid resistance. Thus, if tablets were taken, the antibiotic would be destroyed. The half-life of piperacillin is 60 minutes. In principle, the use of piperacillin is suitable at any age.
Risks and side effects
Administering piperacillin may result in unwanted side effects in some patients. However, this is not the case for everyone, as there are large individual differences. The most common side effects include inflammation of the mucous membrane, allergic reactions, skin rashes, itching, redness on the skin, headache, and an increase in blood urea concentration. In the case of high dosages, bleeding on the mucosa is also conceivable.Joint pain, drug fever, serum sickness, swelling of the throat, inflammation of the kidneys, allergic vasculitis, Stevens-Johnson syndrome, and deficiency of hemoglobin are sometimes seen. Especially in the initial phase of piperacillin treatment, severe diarrhea occasionally manifests itself and lasts longer. This may involve the life-threatening intestinal disease pseudomembranous colitis. An outbreak of urticaria is considered an indication of penicillin allergy. In this case, treatment with the antibiotic must be discontinued immediately. If the patient suffers from hypersensitivity to penicillin or cephalosporin, therapy with piperacillin should be avoided. The administration of penicillin is also not recommended during pregnancy and breastfeeding, as there is no precise knowledge about the safety of the drug during this period. In addition, attention should be paid to interactions with other medications. This is especially true for other penicillins or cephalosporins. It delays their degradation when taken at the same time, which leads to a prolonged effect. In addition, piperacillin increases the level of methotrexate in the blood. Enhancement of the effect of piperacillin is possible with the administration of non-steroidal anti-inflammatory drugs such as salicylates, phenylbutazone, sulfinpyrazone or indometacin. The same is true for the gout medication probenecid.
