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Piperacillin is an broad-spectrum β-lactam antibiotic of the ureidopenicillin class. The chemical structure of piperacillin and other ureidopenicillins incorporates a polar side chain that enhances penetration into Gram-(-) bacteria and reduces susceptibility to cleavage by Gram-(-) beta lactamase enzymes. These properties confer activity against the important hospital pathogen ''Pseudomonas aeruginosa''. Thus piperacillin is sometimes referred to as an "anti-pseudomonal penicillin". When used alone, piperacillin lacks strong activity against the Gram positive pathogen ''Staphylococcus aureus'', as the beta-lactam ring is broken by the bacteria's beta-lactamase.〔Hauser, AR ''Antibiotic Basics for Clinicians'', 2nd Ed., Wolters Kluwer, 2013, pg 26-27〕 Piperacillin is most commonly used in combination with the beta-lactamase inhibitor tazobactam (piperacillin/tazobactam) (tradename "Zosyn"), which enhances piperacillin's effectiveness by inhibiting many beta lactamases to which it is susceptible. The co-administration of tazobactam does not confer activity against methicillin-resistant Staphylococcus aureus, however, as penicillins (and most other beta lactams) do not avidly bind to the penicillin-binding proteins of this pathogen. ==Medical uses== Piperacillin is used almost exclusively in combination with the beta lactamase inhibitor tazobactam for the treatment of serious, hospital-acquired infections. This combination is among the most widely used drug therapies in United States non-Federal hospitals, accounting for $388M in spending in spite of being a low-cost generic drug. Piperacillin-tazobactam is recommended as part of a three drug regimen for the treatment of hospital-acquired pneumonia suspected as being due to infection by multi-drug resistant pathogens.〔Mandell LA, Wunderink R, in ''Harrison's Principles of Internal Medicine'' 18th Ed., Chapter 257, pp 2139-2141〕 It is also one of several antibacterials recommended for the treatment of infections known to be caused by anaerobic Gram-(-) rods.〔Kasper DL, Cohen-Poradosu R, in ''Harrison's Principles of Internal Medicine'' 18th Ed., Chapter 164, pp 1331-1339〕 Piperacillin-tazobactam is recommended by the National Institute for Health and Care Excellence as initial empiric treatment for people with suspected neutropenic sepsis. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Piperacillin」の詳細全文を読む スポンサード リンク
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