PIPERACILLIN/TAZOBACTAM INTRAVENOUS

DESENSITIZATION (ZOSYN)
Materials:
Zosyn (2 gm/0.25 gm) in 50 mL (eqivalent of 40 mg/mL piperacillin) LAST bag to be used
Serial 10 fold dilutions in normal saline
Can be prepared as follows in the pharmacy:
1:10 (4 mg/mL) 20 mL of 40 mg/mL + 180 mL saline THIRD bag to be used
1:100 (0.4 mg/mL) - 20 mL of 4 mg/mL + 180 mL saline SECOND bag to be used
1:1000 (0.04 mg/mL) - 20 mL of 0.4 mg/mL + 180 mL saline FIRST bag to be used
Procedure:
1.
2.

Infuse the indicated concentration of drug for 15 minutes at the flow rate indicated.
Then change the flow rate, and if necessary the concentration of drug, and continue with the
increasing doses until the protocol has been completed.
3. This will constitute the first total dose of Zosyn.

4.
Dose

Usual doses and intervals can then be instituted.

Concentration

Flow rate

Time

Amount given

Total given

1
2
3
4
5

0.04 mg/mL
0.04 mg/mL
0.04 mg/mL
0.04 mg/mL
0.04 mg/mL

10 mL/hr
20 mL/hr
40 mL/hr
80 mL/hr
160 mL/hr

15 min.
15 min.
15 min.
15 min.
15 min.

0.1 mg
0.2 mg
0.4 mg
0.8 mg
1.6 mg

0.1 mg
0.3 mg
0.7 mg
1.5 mg
3 mg

6
7
8
9

0.4 mg/mL
0.4 mg/mL
0.4 mg/mL
0.4 mg/mL

30 mL/hr
60 mL/hr
120 mL/hr
240 mL/hr

15 min.
15 min.
15 min.
15 min.

3 mg
6 mg
12 mg
25 mg

6 mg
12 mg
24 mg
50 mg

10
11
12

4 mg/mL
4 mg/mL
4 mg/mL

50 mL/hr
100 mL/hr
200 mL/hr

15 min.
15 min.
15 min.

50 mg
100 mg
200 mg

100 mg
200 mg
400 mg

13
14

40 mg/mL
40 mg/mL

40 mL/hr
80 mL/hr

15 min.
15 min.

400 mg
800 mg

800 mg
1600 mg

Com