Zosyn has been approved for the treatment of moderate to severe nosocomial (hospital-acquired) pneumonia caused by piperacillin-resistant beta-lactamase-producing strains of Staphylococcus aureus. Nosocomial pneumonia is a disease that has proven increasingly resistant to many available antibiotics.
Zosyn is an injectable antibiotic consisting of beta-lactamase inhibitor, tazobactam, in combination with an extended-spectrum penicillin, piperacillin. The piperacillin component offers the safety and efficacy of a broad-spectrum, beta-lactam antibiotic. Tazobactam reduces the vulnerability of Zosyn to bacteria that produce beta-lactamase enzymes.
Because of its broad spectrum of bactericidal activity against gram-positive and gram-negative aerobic and anaerobic organisms, Zosyn is also indicated as monotherapy for intra-abdominal infections (specifically appendicitis and peritonitis); skin and skin structure infections including cellulitis, cutaneous abscesses and ischemic/diabetic foot infections; and gynecologic infections (postpartum endometriosis and pelvic inflammatory disease).
In a multicenter study of 300 subjects with nosocomial pneumonia, the rate of clinical cure or improvement for Zosyn plus tobramycin was 74%, compared with 50% for ceftazidime plus tobramycin (p is less than .01). The Zosyn regimen eradicated 78% of all pathogens, compared with 57% in the ceftazidime group.
Side effects included diarrhea (20%), constipation (8.4%), agitation (7.1%), and nausea (5.8%).
Nosocomial pneumonia accounts for more than 40% of all infection-related hospital deaths. It is the most common hospital-acquired infection among intensive care subject. On average, this infection adds seven days to the duration of hospitalization. There are an estimated six cases of nosocomial pneumonia for each 1,000 hospital discharges. Among elderly subjects, the incidence climbs to 17 cases per 1,000 discharges.