The use of piperacillin–tazobactam in neonatal and paediatric patients

Abstract

Background: Piperacillin–tazobactam (PIP/TAZO) has been extensively used in adults with nosocomial infections and with fever and neutropenia. The available data considering the use of PIP/TAZO have not been reviewed in detail. Objective: Review discussing the use of PIP/TAZO in neonatal and paediatric patients. Methods: Medline search focusing on articles published in English. Owing to the paucity of randomized controlled trails, uncontrolled studies and case series were included. Results/conclusion: PIP/TAZO may safely be used in paediatric patients as an empiric treatment for serious infections in hospital environments where resistance to common first-line antimicrobials has emerged. The most common indications in paediatric patients are nosocomial infections owing to resistant Gram-negatives, exacerbation of pulmonary colonization with Psuedomonas aeruginosa in patients with cystic fibrosis, intra-abdominal infections, fever and neutropenia in paediatric cancer patients. The influence of PIP/TAZO routine use on the selection of extended-spectrum beta-lactamase producing Gram-negatives and on the prevalence of vancomycin-resistant enterococci is still a matter of debate. In particular the use of PIP/TAZO in neonates and PIP/TAZO monotherapy in paediatric cancer patients with fever and neutropenia should be investigated in prospective randomized studies including a sufficient number of patients.