Abnormal Functioning of Kidneys
Patients with abnormal functioning of kidneys are at an increased risk when using this medicine. During the combined therapy with other penicillins when high doses of Zosyn are given, irregular movement of the body (seizures
) and brain complications can occur.
Development of Drug-Resistant Bacteria
Giving Zosyn in the absence of a completely suspected bacterial infection or a preventive
indication is unlikely to give an advantage to the patient. Therefore, enhances the risk of the growth of drug-resistant bacteria.
Clostridium difficile-associated diarrhea
has been observed over two months of Zosyn use and may vary in severity from moderate diarrhea to life-threatening inflammation of the colon. Treatment with Zosyn changes the normal flora of the colon leading to overgrowth of C. difficile, contributing to hospital-acquired diarrhea. These can cause an increased fatality and disease rate. Patients may require the removal of the colon in such condition. If CDAD is suspected or confirmed, Zosyn uses against C. difficile needs to be discontinued. Suitable fluid and electrolyte use, protein supplementation, antibacterial therapy of C. difficile, and operational
evaluation should be started as indicated.
Patients requiring restricted salt
intake are at an increased risk when using this medicine. Regular checking of electrolyte should be done in patients with low potassium
. The possibility of low potassium should be kept in mind with patients having low potassium reserves and who are taking cytotoxic treatment or diuretics
Kidney Damage in Critically Ill Patients
The use of Zosyn was known to be an independent risk factor for kidney failure. It was associated with slowed recovery of the functioning of kidneys as compared to other beta-lactam drugs in critically ill patients. The combined use of Zosyn and vancomycin may be related to an increased rate of acute kidney injury. Based on this research, alternative therapy options should be taken into consideration in the critically ill group. If alternative therapy options are unavailable, observe the functioning of kidneys.
Central Nervous System Side Effects
Patients may undergo spasm of nerves and muscles or convulsions if larger than recommended doses are delivered through veins (especially in the presence of kidney failure).
Patients with kidney failure are at a greater risk when using this medicine. Bleeding
signs have occurred in some patients taking piperacillin. These reactions sometimes are known to be associated with irregularities in blood clotting tests such as platelet
aggregation, clotting time, and prothrombin time. The decreased amount of white blood cells associated with Zosyn use appears to be reversible and most often linked with long-term use. Recurrent evaluation of the process of blood cells formation should be performed, particularly with prolonged therapy that is 21 days. If bleeding signs occur, Zosyn should be discontinued and began appropriate treatment.
Severe Skin-Related Side Effects
Zosyn can cause severe skin side effects, such as severe skin reaction, drug reaction with elevated levels of eosinophils
and systemic symptoms, and sudden skin eruptions. If patients acquire a skin rash, close monitoring should be done and discontinue Zosyn if lesions progress.
Individuals with a history of cephalosporin, penicillin, or carbapenem allergy
or a previous history of sensitivity to various allergens are at an increased risk when using this medicine. Serious and infrequently fatal allergic reactions (including shock
) have been seen in patients undergoing therapy with Zosyn. Before starting therapy with Zosyn, careful analysis should be done concerning previous allergic reactions. If any allergic reaction occurs, Zosyn should be discontinued and institute proper treatment.