Safety and tolerability of i.v. push piperacillin/tazobactam within an emergency department

Am J Health Syst Pharm. 2020 Jun 23;77(13):1051-1053. doi: 10.1093/ajhp/zxaa114.


Purpose: Piperacillin/tazobactam is a broad-spectrum antibiotic that is widely used and commonly administered via the intravenous (i.v.) piggyback route over 0.5 to 4.0 hours. Recommendations for i.v. push (IVP) administration of piperacillin/tazobactam are lacking due to the high osmolality of the solution. The primary objective of this study was to retrospectively assess the safety and tolerability of piperacillin/tazobactam administered peripherally by IVP. Methods. A retrospective chart review was conducted to evaluate adverse drug reactions after administration of a single dose of IVP piperacillin/tazobactam through a peripheral line in an emergency department from August 2016 through November 2017.

Results: A total of 1,813 patients received 1 dose of IVP piperacillin/tazobactam during the study timeframe. Three hundred patients were randomly selected for assessment of safety and tolerability. Two hundred ninety-nine patients (99.7%) tolerated IVP piperacillin/tazobactam. One patient had an allergic reaction that included itching and hives. No infusion-related reactions were documented.

Conclusion: IVP administration of piperacillin/tazobactam through a peripheral site is safe and tolerable for adult patients.

Keywords: Zosyn; beta-lactams; drug safety; i.v. push antibiotics; infectious disease; piperacillin/tazobactam.

MeSH terms

  • Academic Medical Centers / methods
  • Administration, Intravenous / methods*
  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Piperacillin, Tazobactam Drug Combination / administration & dosage*
  • Piperacillin, Tazobactam Drug Combination / adverse effects
  • Retrospective Studies
  • Urticaria / chemically induced


  • Anti-Bacterial Agents
  • Piperacillin, Tazobactam Drug Combination