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piperacillin (piperacillin, KRKA / Isipen)

✓ Approved

Krka · Small Molecule · Small Molecule

What is piperacillin?

piperacillin is a small molecule developed by Krka. It is approved for therapeutic indications via unknown.

Drug Profile

Brand Namespiperacillin, KRKA, Isipen
CompanyKrka
Drug ClassSmall Molecule
RouteUnknown
StatusApproved
Sources: ClinicalTrials.gov, Krka

Therapeutic Indications

piperacillin is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Infections and infestationsSalmonellosis✓ Approved

Related Research Articles

PubMedFrontiers in cellular and infection microbiology2026-10-15

Fingolimod potentiates minocycline against multidrug-resistant Elizabethkingia.

Sun Jie J, Feng Qiang Q, Yang Can C, Zong Yulong Y et al.

Elizabethkingia spp. are intrinsically resistant to multiple antimicrobial classes and are emerging nosocomial pathogens. This study evaluated the antibacterial activity of fingolimod against Elizabethkingia and its interaction with minocycline. Sixteen residual clinical isolates were examined. Baseline single-agent susceptibility was assessed by a single disk-diffusion determination and by VITEK 2. Fingolimod MIC and MBC values were measured by broth microdilution. Biofilm formation was quantified by crystal violet staining. Fingolimod-minocycline interactions were evaluated by checkerboard and time-kill assays. Preliminary protective activity was examined in a Galleria mellonella model infected with EA12. Disk diffusion and VITEK 2 showed method-dependent discordance for piperacillin-tazobactam. Fifteen of 16 isolates formed biofilm; 13 of these 15 were weak and two were moderate producers. Fingolimod MICs ranged from 6.25 to 25 μg/mL. Fingolimod reduced the minocycline MIC by 4-8-fold in six synergistic isolates. The combination produced preliminary, isolate-specific protection in Galleria mellonella infected with EA12. Fingolimod exhibits antibacterial activity against Elizabethkingia spp. and potentiates minocycline in a subset of isolates. These findings support further development of fingolimod-based combination strategies and optimization of the fingolimod scaffold.

PMID 42876699
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PubMedAntimicrobial agents and chemotherapy2026-10-14

Population pharmacokinetics of piperacillin based on multicenter data to support model-informed precision dosing in critically ill women.

Greppmair Sebastian S, Pesthy Sina S, Zoller Michael M, Scharf Christina C et al.

Sex-specific differences in pharmacokinetics are increasingly recognized as clinically relevant, yet most population pharmacokinetic models for antibiotics have been developed in predominantly male populations with limited transferability to female patients. This study aimed to develop and externally evaluate a population pharmacokinetic model of piperacillin specifically for critically ill women to support model-informed precision dosing (MIPD). A total of 923 samples from 165 critically ill women (from four previously published studies) receiving piperacillin/tazobactam were analyzed. The data set was randomly split into a training set (80%) and an independent external evaluation set (20%). Non-linear mixed-effects modeling was employed based on the training data using NONMEM, and covariates were identified using stepwise covariate modeling with cross-validation. Prediction accuracy and bias were quantified using the median prediction error (MDPE) and the median absolute prediction error (MDAPE) in an MIPD scenario. Model predictions for future concentrations were generated both a priori and through Bayesian forecasting based on one prior sample. A two-compartment model provided the best fit for the data. Clearance was significantly affected by renal function estimated by the Cockcroft-Gault equation, along with procalcitonin and serum albumin. The external evaluation demonstrated strong predictive performance with very low systematic bias. In the MIPD scenario, a priori predictions exhibited good predictive performance (MDPE < |5.2|%, MDAPE < 33.4%), which substantially improved with Bayesian forecasting (MDPE < |3.2|%, MDAPE < 19.1%). A female-specific population pharmacokinetic model of piperacillin was developed and externally validated, demonstrating robust predictive performance and clear benefits for Bayesian forecasting.

PMID 42872928
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PubMedJournal of visualized experiments : JoVE2026-10-14

Trends in Pseudomonas aeruginosa Resistance After a Four-Dimensional Antimicrobial Stewardship Intervention.

Huang Yin Y, Haung Xin X, Song Xudong X, Ding Fan F et al.

This single-center retrospective study analyzed de-duplicated Pseudomonas aeruginosa isolates collected at Huaian Municipal Infectious Diseases Hospital from 2023 to 2025. A total of 121 unique isolates were included, of which 83.5% were from sputum. Antimicrobial susceptibility testing (AST) was performed using an automated microbiology system, and minimum inhibitory concentration (MIC) results were interpreted according to CLSI M100, 33rd edition. In early 2024, a four-dimensional linkage-targeted antimicrobial stewardship intervention was implemented in the Respiratory and Tuberculosis Department (Resp-TB) (n = 97), comprising: (1) dynamic antimicrobial resistance surveillance with quarterly feedback; (2) risk-stratified antimicrobial prescribing based on local susceptibility data; (3) standardized specimen collection protocols; and (4) enhanced infection prevention and control measures. In the Resp-TB, the overall resistance rates were 74.19% in 2023, 81.63% in 2024, and 82.93% in 2025, with no significant reduction after the intervention (p ≈ 0.37). By 2025, resistance to tobramycin was 0/41 (0.00%), cefepime was 1/41 (2.44%), and piperacillin-tazobactam was 0/41 (0.00%); levofloxacin resistance reached 15/41 (36.59%). Trimethoprim-sulfamethoxazole resistance remained high across the study period. These findings show persistent antimicrobial resistance in the Resp-TB after implementation of the intervention, while resistance to selected agents, including tobramycin, cefepime, and piperacillin-tazobactam, remained low in 2025.

PMID 42872723
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PubMedFrontiers in medicine2026-10-14

Q fever with biliary dilatation following contact with muntjac deer: a case report.

Mao Wulong W, Yang Yuping Y, Yu Xinghao X, Wu Chenxi C et al.

Q fever is a zoonosis caused by Coxiella burnetii. Classic presentations include atypical pneumonia and hepatitis, but bile duct dilation on imaging is rarely described. We report a case of acute Q fever in an urban resident of Chengdu, Sichuan Province, Southwestern China, who presented with cholestatic liver injury and intra- and extrahepatic bile duct dilation, highlighting an unusual manifestation that mimicked biliary tract disease. A 53-year-old man was admitted with persistent high fever (up to 41.8 °C), headache, chills, and right upper quadrant pain. Laboratory tests showed cholestatic hepatitis (AST 132 U/L, ALT 110 U/L, ALP 221 U/L, GGT 231 U/L), with normal total and direct bilirubin. Magnetic resonance cholangiopancreatography (MRCP) revealed mild intra- and extrahepatic bile duct dilation without obstruction. The patient had no livestock contact but had been exposed to wild muntjac deer from informal sources. Empiric doxycycline combined with piperacillin-tazobactam led to rapid defervescence and symptom improvement. The diagnosis of acute Q fever was supported by metagenomic next-generation sequencing (mNGS) of peripheral blood, in the absence of confirmatory seroconversion. In this case, bile duct dilation without jaundice was a notable manifestation of the infection. For febrile patients with unexplained cholestasis and bile duct dilation, especially those with a history of contact with wild animals, Q fever should be considered in the differential diagnosis.

PMID 42871002
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PubMedAME case reports2026-10-14

Urogenital abscess with a complex etiology: a case report.

Narcelles Natalie Grace NG, Akinpelu Afolabi David AD, Sarap Michael Duke MD

Scrotal abscesses requiring hospitalization are uncommon, with progression to sepsis being even rarer. A feared complication of a scrotal abscess is Fournier gangrene, an uncommon type of necrotizing fasciitis that starts in the scrotum or perineum. Fournier gangrene is associated with a mortality rate of about 40% and accounts for less than 0.02% of all hospital admissions. The patient in this report was hospitalized for a complex scrotal abscess and, during repeat incision and drainage (I&D), was found to have Fournier gangrene. The patient was a 49-year-old male who presented with acute left-sided perineal pain. His medical history was significant for severe obesity, uncontrolled diabetes mellitus (DM) type 2, and hypertension (HTN). Physical examination showed no superficial signs of an abscess. Computed tomography (CT) of the abdomen and pelvis was inconclusive. Further workup revealed borderline tachypnea [20 breaths per minute (bpm)], elevated white blood cell count (WBC) (27.60 K/mcL), tachycardia (128 bpm), and a probable source of infection. The patient met septic criteria according to the Systemic Inflammatory Response Syndrome Criteria (SIRS). He was started on intravenous (IV) vancomycin [1,750 mg every 12 hours (q12h) ×2 days to 2,000 mg q12h ×7 days], and IV piperacillin-tazobactam (3.375 mg q8h ×9 days). Clinical decision-making warranted a surgical consult and, thus, immediate I&D. The patient's infection failed to improve. Additional imaging, transfer to a tertiary hospital, and repeat I&D led to more advanced findings. The patient was found to have a scrotal abscess that tracked through the perineum to the ischium. He was diagnosed intraoperatively with Fournier gangrene and was admitted for continued monitoring and IV antibiotics. After discharge and multiple follow-up visits with wound care, the patient made a full recovery. This case report showcased an uncommon presentation of a male with a urogenital abscess. A patient presenting with a urogenital abscess complicated by sepsis should prompt a clinician to have a high index of suspicion for Fournier gangrene. Broad-spectrum IV antibiotics should be initiated as quickly as possible, and a general surgery consult should be placed for I&D. This case highlights the importance of urgent intervention in reducing mortality secondary to Fournier gangrene as well as maintaining the function of urinary and sex organs.

PMID 42871345
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PubMedAnnals of intensive care2026-10-13

Early piperacillin exposure during continuous infusion in critically ill patients: the impact of renal and liver dysfunctions.

Conseil Matthieu M, Lakbar Inès I, Laurino Alina A, Evsen Suheda S et al.

To assess early piperacillin exposure in critically ill patients receiving continuous infusion piperacillin-tazobactam, identify clinical determinants of underexposure and overexposure, and evaluate piperacillin concentrations across organ dysfunction phenotypes. Retrospective, single-center observational study. A 20-bed medical-surgical intensive care unit of a university hospital. All consecutive adult critically ill patients receiving continuous-infusion piperacillin-tazobactam with at least one total plasma piperacillin concentration measurement. None. Observed plasma piperacillin concentrations were measured at predefined time points (day 1, day 3 and day 7). Target attainment was defined as total plasma concentrations of 80-160 mg/L, corresponding to 4-8 times the minimum inhibitory concentration of Pseudomonas aeruginosa.A total of 350 patients were included, contributing 775 piperacillin measurements. At first sampling (day 1), 30% of patients were underexposed, 35% achieved the target range, and 35% were overexposed. In multivariable analyses, underexposure was less frequent in older patients and in those with renal dysfunction or shock, while male sex was independently associated with a higher risk of underexposure. Overexposure was strongly associated with renal dysfunction, higher bilirubin concentrations, and higher daily piperacillin dose. Piperacillin concentrations were highest in patients with combined hepato-renal dysfunction. Only one-third of critically ill patients achieved target piperacillin exposure at initial therapeutic drug monitoring during continuous infusion. Early deviations from target concentrations were frequent and primarily determined by renal dysfunction despite routine dose adjustment. These findings support early individualized dosing strategies integrating organ function assessment and therapeutic drug monitoring to optimize piperacillin exposure.

PMID 42866585
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