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中文药名：特治星（哌拉西林/他佐巴坦钠）注射剂
英文药名：Tazocin（Piperacillin/Tazobactam）
分类名称
一级分类：抗生素 二级分类：其他β内酰胺类 三级分类：
药品英文名
Piperacillin Sodium/Tazobactam Sodium
药品别名
哌拉西林/三唑巴坦、哌拉西林/他佐巴坦、哌拉西林/泰唑巴坦、康力得、邦达、锋泰灵、哌拉西林钠/他唑巴坦钠、派拉西林钠/三唑巴坦钠、特治星、Tazocin、Zosyn
药物剂型
注射剂(粉):2.25g，4.5g。
药理作用
哌拉西林/他唑巴坦为哌拉西林钠与β-内酰胺酶抑制剂他佐巴坦钠组成的复方广谱抗生素。哌拉西林为半合成的广谱青霉素，属酰脲类青霉素。其抗菌作用机制与青霉素相似，通过与细菌主要青霉素结合蛋白(PBPs)结合，干扰细菌细胞壁的合成而起抗菌作用。
其特点是广谱，但不耐青霉素酶。他佐巴坦又名三氮甲基青霉烷砜，是一种青霉素酸砜，为β-内酰胺酶的抑制剂。它自身几乎没有抗菌活性，但具有强效广谱抑酶作用。其抑酶作用机制是它能与β-内酰胺酶结合，发挥竞争性抑制作用，可暂时性抑制β-内酰胺酶，从而保护酶的作用底物β-内酰胺类抗生素不被酶水解灭活。他佐巴坦对青霉素酶和氧亚胺头孢菌素酶的抑制活性与克拉维酸相似，而对头孢菌素酶的抑制活性强于克拉维酸和舒巴坦。
本药抗菌谱包括:
1.大肠埃希菌、枸橼酸菌属、克雷白杆菌属、肠杆菌属、普通变形杆菌、奇异变形杆菌、雷氏普罗维登斯菌、斯氏普罗维登斯菌、毗邻单胞菌类志贺菌、摩氏摩根菌、沙雷菌属、沙门菌属、志贺菌属、假单胞菌属、淋病奈瑟菌、脑膜炎球菌等革兰阴性菌；
2.链球菌属、肠球菌、金黄色葡萄球菌、腐生葡萄球菌、表皮葡萄球菌、凝固阴性葡萄球菌、棒状杆菌属、单核细胞增多性李斯德菌、奴卡菌属等革兰阳性菌；
3.类杆菌属、类杆菌属脆弱杆菌族、消化链球菌属、梭杆菌属、真细菌族、梭状芽胞杆菌属、费氏球菌属及放线菌属等厌氧菌。
药动学
本药肌内注射后吸收完全。绝对生物利用度哌拉西林为71%，他唑巴坦为83%。肌内注射后40～50min达血药浓度峰值，静脉注射或静脉滴注后即达血药峰值浓度。药物吸收后在体内广泛分布于包括痰、肾、胆汁、胆囊、腹腔液、扁桃体、皮肤、女性性器官在内的组织和体液中。组织中药物浓度与血药浓度接近或稍高。在血药浓度高于100μg/ml时，本药与血浆蛋白结合率分别为21%和23%。健康人单次或多次用药后，其血浆清除半衰期约为0.7～1.2h，且不受注入药物剂量或所用时间的影响，但可随着肌酐清除率的降低而延长。在肌酐清除率低于每分钟20ml时，哌拉西林和他唑巴坦的半衰期比肾功能正常者分别延长2和4倍。哌拉西林在人体内不经过生物转化，他唑巴坦经代谢转化成没有抗菌活性的单一代谢产物；哌拉西林钠/他唑巴坦钠通过肾小球滤过和主动分泌由肾脏排至体外；哌拉西林约69%以原形随尿液快速排泄，另有部分可随胆汁排泄。他唑巴坦及其代谢产物主要由肾脏排泄清除，其中约80%为药物原形而其余的则为代谢物。血液透析可清除血液中部分哌拉西林和他唑巴坦，清除量约分别为给药剂量的31%和39%。
适应证
本药适用于治疗敏感菌所致的急慢性呼吸道感染、泌尿及生殖系统感染、胆道感染、皮肤及软组织感染、败血症等。
禁忌证
1.对本药任一成分过敏者。
2.对其他β-内酰胺类抗生素、β-内酰胺酶抑制剂过敏者。
注意事项
1.慎用:
(1)孕妇、哺乳期妇女；
(2)严重肝、肾功能障碍者；
(3)高度过敏性体质者。
2.药物对儿童的影响:12岁以下儿童的用药安全性及剂量尚未正式确定。
3.药物对检验值或诊断的影响:
(1)直接抗人球蛋白(Coombs)试验可呈阳性反应；
(2)硫酸铜法测定尿糖时可呈假阳性；
(3)少数患者用药后可出现血尿素氮和血清肌酐升高、血清氨基转移酶和血清乳酸脱氢酶、血清胆红素升高。
不良反应
本药不良反应多为轻、中度，且呈短暂性。不良反应总发生率约为2.2%～4.4%，与剂量无一定的倾向性关系。
1.过敏反应：常见皮疹(如荨麻疹)瘙痒、及皮肤湿疹样改变等过敏反应；偶见药物热、过敏性休克等。
2.胃肠道反应：用药后可出现腹泻、恶心、呕吐、便秘、食欲减退、消化不良等胃肠道症状；偶见假膜性肠炎。
3.肝毒性：少数患者用药后可出现暂时性肝功能异常、胆汁淤积性黄疸。
4.肾毒性：少数患者用药后偶可出现肾损害。
5.中枢神经系统：用药后偶见头痛、焦虑、烦躁不安等中枢神经系统症状。
6.二重感染：长期用药时可致菌群失调，发生二重感染。
7.其他：肌内或静脉给药时可致注射部位疼痛、硬结，严重者可致血栓性静脉炎。
用法用量
1.成人:
(1)肌内注射：每次4.5g，每8小时1次。
(2)静脉给药：每次4.5g，每8小时1次。
2.儿童:
(1)肌内注射：12岁以上患儿的常用剂量为每次4.5g，每8小时1次。
(2)静脉给药：12岁以上患儿的常用剂量为每次4.5g，每8小时1次。
药物相应作用
1.本药与阿米卡星、庆大霉素或妥布霉素等氨基糖苷类药联用对假单胞菌属、沙雷菌属、克雷白菌属、吲哚阳性变形杆菌、普鲁威登菌、其他肠杆菌属细菌和葡萄球菌的敏感菌株有协同杀菌作用。
2.本药和某些头孢菌素联用对大肠埃希菌、假单胞菌属、克雷白菌属和变形杆菌属的某些敏感菌株有协同抗菌作用。
3.本药与丙磺舒合用时，丙磺舒可减少哌拉西林在肾小管的排泄，使哌拉西林的血药浓度增高。有报道肌内注射前1h口服丙磺舒可使哌拉西林血药浓度增加30%，半衰期延长30%。
4.本药与非甾体抗炎止痛药，如阿司匹林、二氟尼柳(diflunisal)以及其他水杨酸制剂合用可发生血小板功能的累加抑制作用，增加出血的危险性。
5.本药与肝素、香豆素、茚满二酮等抗凝血药合用可能导致凝血机制障碍和增加出血的危险。
专家点评
本品为哌拉西林与他唑巴坦的复合制剂。两药合用既扩大了抗菌谱，又增强了抗菌活性。哌拉西林/他唑巴坦治疗中、重型细菌性感染，用亚胺培南/西司他丁作对照，哌拉西林/他唑巴坦4.5g静脉滴注，每8～12小时1次，治疗下呼吸道、泌尿生殖道、皮肤及软组织、腹腔内及其他感染，疗程7～14天。哌拉西林/他唑巴坦有效率92.59%，治愈率79.63%，细菌清除率91.49%，不良反应发生率4.40%。体外抗菌活性测定表明，哌拉西林/他唑巴坦活性明显优于哌拉西林，稍较亚胺培南为差，对革兰阳性菌与阿莫西林/克拉维酸相似，对革兰阴性菌与头孢他定相似。
哌拉西林/他佐巴坦是一高效、安全、广谱抗菌药物，对各种中、重型细菌性感染的疗效与亚胺培南/西司他丁相似，两者副作用发生率相近。哌拉西林/他唑巴坦对下呼吸道、泌尿系细菌感染、尤其是产酶菌引起的感染，临床疗效好且不良反应少，是一种高效、安全的抗菌药物。
Tazocin®Zosyn®Tazobactam Sodium, Piperacillin Sodium Solution for injection
What is this medicine?
PIPERACILLIN; TAZOBACTAM (pi PER a sil in; ta zoe BAK tam) is a penicillin antibiotic. It is used to treat certain kinds of bacterial infections. It will not work for colds, flu, or other viral infections.
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
•bleeding problems
•kidney disease
•salt restricted diet
•an unusual or allergic reaction to piperacillin, tazobactam, other penicillin or cephalosporin antibiotics, imipenem, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding
How should I use this medicine?
This medicine is for infusion into a vein. It is usually given by a health care professional in a hospital or clinic setting.
If you get this medicine at home, you will be taught how to prepare and give this medicine. Use exactly as directed. Take your medicine at regular intervals. Do not take your medicine more often than directed.
It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or healthcare provider to get one.
Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
What may interact with this medicine?
•aspirin and aspirin-like drugs
•certain antibiotics given by injection
•medicines that treat or prevent blood clots like warfarin, heparin, enoxaparin, and dalteparin
•methotrexate
•probenecid
•vecuronium used for sleep during surgery
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What should I watch for while using this medicine?
Tell your doctor or healthcare professional if your symptoms do not start to get better or if they get worse. Your doctor will monitor your condition and blood work as needed.
Do not treat diarrhea with over the counter products. Contact your doctor if you have diarrhea that lasts more than 2 days or if it is severe and watery.
This medicine can interfere with some urine glucose tests. If you use such tests, talk with your health care professional.
What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:
•agitation or anxiety
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•chest pain
•difficulty breathing, wheezing
•dizziness
•fast, irregular heartbeat
•fever or chills
•high blood pressure
•high blood sugar
•red spots on the skin
•redness, blistering, peeling or loosening of the skin, including inside the mouth
•seizures
•trouble passing urine or change in the amount of urine
•unusual bleeding or bruising
•unusually weak or tired
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•diarrhea or constipation
•headache
•nausea, vomiting
•pain, swelling, or irritation at site where injected
•stomach upset
•trouble sleeping
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Where should I keep my medicine?
Keep out of the reach of children.
If you are using this medicine at home, you will be instructed on how to store this medicine. Throw away any unused medicine after the expiration date on the label.
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产地国家: 日本
原产地英文商品名:
Tazocin (4/0.5)g/20ml
原产地英文药品名:
piperacillin/ tazobactam
中文参考商品译名:
特治星 (4/0.4)克/20毫升
中文参考药品译名:
哌拉西林/他佐巴坦钠
生产厂家中文参考译名:
日本大棚药品工业株式会社
生产厂家英文名:
日本大棚药品工业株式会社 | 
