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Germany and Italy? Check! 40 days left to the final in St Gilles Croix de Vie, France! The European summer is coming to an end, but before the European riders are heading for the southern hemisphere for the winter months, there is one highlight left: The Kitesurf Tour Europe comes to St. Gilles Croix de Vie (Nantes) from October 26th to November 01st for its final stop and crowns the European Champions in Kiteboarding Freestyle.
Start in Sylt and Lamezia
The tour 2011 started spectacularly on the beautiful island of Sylt, Germany with challenging conditions including 3-4 meter waves and winds around 25 knots. Besides the World Championships in Course Racing and European Freestyle Championships, the Kiteloop Contest and Best Trick competition presented mind-blowing performances in front of a cheering crowd at the island's most famous promenade. Then Lamezia Terme (Naples) in southern Italy welcomed the riders with warm and sunny weather and through its light wind character asked for completely different skills. Thermal winds kicking in late in the day determined the event together with delicious Italian food and famous Calabrian hospitality.
European Champions wanted!
Mario Rodwald from Germany and local French rider Sebastien Garat are the top-favorites to win the title and become European Champion in Kiteboarding Freestyle at the end of the circuit 2011: "After finishing second in the European Championship last year I really put all my commitment into this years tour and hopefully I can make it this time. Some of the guys are really close in the ranking so there´s quite some pressure but it´s going to be good action and also a lot of fun!" states the German champion. Mario used the advantage of competing at home and won the event in the challenging conditions Sylt defeating Seb Garat finishing second as well as Tijn van Esch and Jerrie van de Kop (both Netherlands) in third and fourth place. In Lamezia, competitions went into overtime on the last day due to light winds with Mario and Seb as smiling winners defeating Italian locals Stefano Martinelli and Gabriele Garofalo in the semis. Now the home advantage is on Seb's side and as the tour showed, having a cheering crowd at its back should not be underestimated – excitement, stunning action and close heats are guaranteed!
In the women's competition, Asia Litwin from Poland leads the ranking in front of fellow Polish rider Michalina Laskowska and Sylt winner Ines Correia from Portugal. Here, the race for champion will be very tight with around ten riders able to win the event on a good day: UK-champion Hannah Whiteley, German rider Meike Erichsen as well as Helena Brochocka (POL), Pavla Novotna (CZE), Annie de Jong (NED) and Italy winner Alice Brunacci (ITA) are travelling to St Gilles Croix de Vie (Nantes) for nothing less than the aim to win the event.
Course Racing IKA World Ranking
For the racers, the Kitesurf Tour Europe bears important points for the IKA World Ranking. The French team including current leader Julien Kerneur, Maxime Nocher, Bruno Sroka and Olivier Dansin dominated the races in Italy and battled each other in close runs. Dutch rider Rolf van de Vlucht, Andrea Beverino who showed a great performance at his home spot in Italy as well as young-gun Florian Gruber from Germany are heading for France to challenge the French domination. In the women's division, Katja Roose (Netherlands) was unstoppable winning every single race in Italy. The Dutch who got 2nd in the World Championships on Sylt showed that she is in top shape and difficult to stop this year. Italian rider Alice Brunacci got second in Italy followed by US rider Melissa Gil in third place.
The Grande Finale in St Gilles Croix de Vie (Nantes)
With three and a half kilometres of sandy beach, St. Gilles is a popular summer holiday destination and famous for its old fisherman cottages. The popular village is enthusiastic about all kinds of watersports and one of the best kitesurfing and surfing spots in France. Moreover, St. Gilles Croix de Vie is labeled "France Station Nautique", which proves the city's dynamism in water and extreme sports and capacity to offer the required infrastructures to host an international event. It has a long history in hosting kiteboarding events such as various world and French championship stops and is also home of "Vendée" - organisers of the Vendée Globe, a sailing race around the world.


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The summer of 1892 proved exciting for Denver. The economy boomed, the highly anticipated Brown Palace neared completion and the city hosted the Triennial Conclave of the Knights Templar.
That August, thousands swarmed into Denver for the convention. The hotels that hadn't already been booked quickly filled. With no rooms available, the convention committee begged residents to take lodgers into their homes.
As a result of the influx, on August 6, the Brown Palace opened the unfinished hotel to accomodate the Templars. They provided a few rooms, many sleeping cots in the hallways and a lavish banquet — while workers labored continually on the building.
It wasn't until the next week, on August 12, with preparations completed that the hotel opened to accept the public. Room rates varied from $1, $2 and $3 per night up to $4.50 for the best 100 rooms in the hotel.
The Templar banquet, served in the eighth floor ballroom, included seven courses. The menu, pictured below, offered entrees of Loin of Elk, Roast Rib of Beef and Lamb with Mint Sauce.
(Click on the menu to enlarge.)
Henry C. Brown, a carpenter, contractor and developer, built the Brown Palace. He arrived in Denver with his wife and son in a wagon drawn by oxen in 1860. After setting up a carpentry shop on what is now the Brown Palace site, he erected his first Denver building, a Methodist Church that was swept away in the 1864 Cherry Creek flood. Brown homesteaded the land we call Capitol Hill and sold it off piece by piece to become quite wealthy.
He operated the Denver Tribune for several years, constructed many mansions (including one occupied by Mrs. Augusta Tabor), donated 10 acres for the state capitol site, helped organize the Denver Tramway Company and contributed $1,000 for the construction of Denver's first public library.
Brown did well until the silver crash of 1893, the year after the Brown Palace opened. With fortunes reversed, he had difficulty paying his debts. When foreclosure became inevitable, Brown sold his mortgage to Winfield Scott Stratton, a Cripple Creek gold mine millionaire, for $600,000 and the assurance that Brown could live in the hotel for the remainder of his life.
The hotel has had numerous owners in its 120 years, including Charles Boettcher, and its elegance is known around the world. Some of the Brown Palace's famous clientele include Presidents Teddy Roosevelt, Truman, Eisenhower and Clinton. Others include Eleanor Roosevelt, Queen Marie of Romania, the Beatles, Oprah, Lowell Thomas, Jimmy Stewart and Zsa Zsa Gabor.

subset: commoncrawl


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Gustavo Frazao / Shutterstock.com
Horizon Pharma has filed a complaint against Actavis accusing it of infringing three of patents for the Vimovo (naproxen/esomeprazole magnesium) drug.
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Jeff Belanger will be joining the Ghost Host, Sophia Temperilli and Gian Temperilli on Saturday, Sept 10, at 4 PM (eastern) to talk about all things haunted.
Tune in online at: http://liveparanorma...page/ghost-host
Jeff Belanger on Liveparanormal, 10 Sept
Started by carlotta , Sep 08 2011 02:33 AM
No replies to this topic
Posted 08 September 2011 - 02:33 AM
Who owns the land? Only the land knows. We mortals are passersby, and our lives are but a brief moment in the great span of time and space. We are born, we live out our lives, and most of us do the best we can with it, but the wind is forever, and the rivers flow forever to the sea, and all the seasons of the weathers will come and go after we are gone. But the Earth endures, the Earth is eternal" - Earl Hamner
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Jabberwock B&B Inn
This Craftsman style home was built in 1911, sits on half an acre above Monterey Bay, has seven guest rooms private baths, several with Monterey Bay views, jacuzzi, fireplaces.
Old Monterey Inn Bed and Breakfast
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socialcirclecards are fashionable social networking cards that share your info and piece of your personality too. Customize your custom contact cards with all your social media info: your name, cell number, instagram, twitter, snapchat, blog or more. These personalized social media cards help you stand out from the pack- all while staying right at your side in a case that clips to your favorite bag. socialcirclecards help you make a fashionable first impression.
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socialcirclecards are social networking cards for the 21st century. They make super chic social media cards, the best business cards, fun visiting cards and even work for bloggers as social media business cards- all while looking fashionable and being accessible at the same time.


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Former UH women's basketball coach Joe Curl dies at 59
Recommended Video:
Joe Curl, the popular, "larger than life" personality who was the winningest women's basketball coach in University of Houston history, died Monday after a long battle with heart problems. He was 59.
Angela Curl-Okafor said her father died from congestive heart failure in hospice care in Houston.
Curl suffered a heart attack on a recruiting trip in 2007 and three years later was diagnosed with end-stage heart disease, which forced his retirement.
Curl had been on the active heart transplant list since 2010 until being removed in March.
"We've had a bunch of emotions," Curl-Okafor said. "I think it's gone from complete sadness and being devastated to basically happy that he's no longer suffering. He's gone through a lot."
In 12 seasons at UH, Curl won 193 games and led the Cougars to back-to-back trips to the NCAA Tournament in 2004-05 and three WNIT appearances.
Curl's best season came in 2003-04, when the Cougars won a school-record 28 games, swept the Conference USA regular-season and tournament titles, and won an NCAA Tournament game for the first time. Curl was named Associated Press National Coach of the Year.
Under Curl, former standout Chandi Jones, who played for the Cougars from 2000-04, was named C-USA Female Athlete of the Decade.
Curl compiled a record of 331-252 during a 20-year coaching career that also included stops at Stephen F. Austin, Blinn College and Trinity Valley Community College.
"Joe was a special member of our athletics family, serving not only as head coach but as a mentor to many young women throughout the year," said Mack Rhoades, UH's vice president for intercollegiate athletics. "His presence and larger-than-life personality will be missed by all who had the pleasure to know him."
Curl is survived by his wife of nearly 39 years, Lesa; daughters Curl-Okafor and Jennifer Curl; son-in-law Patrick Okafor; and grandchildren Maverick and Peyton Curl-Okafor and Caleb Curl.
A funeral service for Curl will be held at 7 p.m. Thursday at Rosewood Funeral Home in Pasadena (3939 Pasadena Blvd.). Visitation will begin at 5 p.m.
A cookout honoring Curl, who cooked barbecue at football games and team functions, will begin at noon. Dress for the event is casual.
"We want to do it in his tailgate style," Angela Curl-Okafor said.


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Alto K10 is the elder sibling of the Alto 800 from the Maruti-Suzuki's range. It is the highest selling vehicle in India and it is prefered by most brand for the mid class customers. It is available in Tango Orange, Granite Grey, Fire Brick Red, Silky Silver and Superior White colours.
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For the first time in India you can book a car online. Pay the 'Booking amount' by clicking "BOOK NOW" button. You can pay by using your Credit/Debit card or Inter-bank transfer. Incase you prefer the Cheque payment mode - please inform us the best suitable time and our authorised dealer partners will be happy to collect the cheque from your address
Our 'After sales team' will contact you to confirm your booking details withing 24hours of the booking. MYNEWCAR will co-ordinate will the dealer and will act as your personal concierge to keep you updated untill your car is delivered. The balance payment will be paid to the dealer at the time of delivery
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The car will be delivered by MYNEWCAR Authorised Dealer partner in your respective city.
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Peters Elementary School
Peters Elementary School in located at 851 NW 68 Avenue Plantation, FL 33317 Tel: (754) 322-7900. Below are homes tailored with in the school district for you to conveniently select from. The list includes pictures, prices and details updated daily. Please contact us for private viewings.
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Directed by Dr. Vijay Pande, the award-winning team at Stanford University's Pande Lab has been responsible for several advances in the fields of theoretical biophysical chemistry. Our lab has a diverse group of people, with backgrounds including physical science (physics, chemistry), statistics, computer science, biology, and biomedicine. Current Group … Learn More
© 2020 Vijay Pande and Stanford University · Website design by Viewfarm


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2013 Relay For Life at Rockhampton 18th - 19th May
To view full list of 2013 RFL pics ... click here
To view Emu Park Team only 2013 RFL pics ... click here
To view Coastal Kids Team only 2013 RFL pics ... click here
The event was magnificent but very, very cold. Owing to a few days heavy rain prior to the relay the walking track deteriorated overnight which caused officials to divert the walk and eventually had to stop walking at 1am. Walking recommenced at 5.30am till the finish at 8am.
It was great to see the Gang from Emu Parks Coastal Kids backing up from last year. They were good fun to be neighbours with. (but all those kids... should of been in childcare) .."only joking" The kids enjoyed the night.
Over 110 teams participated and at the conclusion of the event the fundraising tally had reached $200,000.00. Now that tally will raise considerably with late deposit of pledges.
Good old Emu Park Online was one of only a handful of teams that had been involved in every Relay. We've done the whole 11, and are ready to go again.
We had some great sponsors this year in particular Tegan Tuscott who through her Pineapple Princes nominated our EPOL Relay Team as her major charity. Also Emus Resort (Backpackers) and the EP Post Office and EP News to name a few.
Anyhow back to the gallery. Our mad photographers Rob Tait and Mark Oscar Hodges took heaps of pics during the night.
Enjoy the pics and thanks Rob and Mark for the great effort.
|This photo gallery has no pictures.
Message from Rob .... As usual we offer to email you larger photos if you require. All photos are royalty free for personal use only. You MUST ask for permission to use photos in any other way. We prefer that you do not print from the photos on the wesite as quality will be average. Please apply for larger copies.


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Over five years ago, Kerry King felt very sick with prolonged episodes of nausea, loss of appetite, shortness of breath, and swelling. She visited a community-based medical clinic, but her blood pressure was so high, they sent her to a local hospital where where she was diagnosed with congestive heart failure and an enlarged heart.
After her diagnosis, an ambulance rushed Kerry to Emory University Hospital where she was admitted to an intensive care unit and diagnosed with a rare lung disorder, primary pulmonary hypertension (PPH.) PPH is characterized by increased pressure in the pulmonary artery, whereby the pulmonary artery carries oxygen-poor blood from the lower chamber on the right side of the heart to the lungs where it picks up oxygen.
After a heart catheterization and battery of other tests, Kerry was discharged from Emory University Hospital and returned home to Henry County with around-the-clock intravenous medication to mange the symptoms. On medication 24/7 for nearly five years, Kerry was forced to live a very limited lifestyle. Daily tasks became a major challenge, "I couldn't even walk up the stairs to the bedroom at night – my husband carried me." Trips to the hospital became more frequent and it became clear something had to be done.
Two days after Christmas in 2009, Kerry was placed on a lung transplant list at Emory, for not just one, but a double lung transplant. With her condition worsening by the day and after being informed she had about six weeks to live, all she could do was wait. And with nearly 2,000 people in the U.S. currently awaiting a lung transplant, finding two lungs for Kerry's transplant had the potential to pose a serious barrier in saving the life of this Hampton, GA native.
Less than a month later, the good news came, and now, Kerry counts herself among the most lucky to have found a double lung transplant in time to save her life. Today, just over a year removed from her life-transforming experience, Kerry counts her lucky charms in the gifts that surround her each day, her twin sons, Justin and Austin, and the second chance at life she has thanks to her transplant that took place at Emory University Hospital.
After months of rehabilitation, Kerry returned home from the hospital. That night, Kerry was enjoying her family and when bedtime for her twins came around, her son Justin went to the stairs and called to his Daddy to complete the only nightly routine he remembered in his young life, "Daddy, it's time for you to carry Mommy upstairs." But on this night, for Kerry, those stairs were no longer a challenge.
Tags: double lung transplant, local, lung transplant, lung transplantation, patient story, transplant center, transplant milestone


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ALEX Toys Bag For The Tub
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Please check your favorite toy retailer for availability. Prices may vary.
Product Description
Use Bag for the Tub to keep bath time toys tidy and organized. The fast-drying, colorful mesh bag that hangs easily and conveniently on soft, playful suction cup hooks that are easy to mount. Available with either duck or frog hooks.
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1) Script Title:
Universal Countdown
2) Script URL (on DD):
3) Describe problem:
Would it be possible to ensure that the Hours, Minutes and Seconds (only) fields always be 2 digits? In other words, "01" instead of "1". This is not important for the days, because the days can be 1, 2 or 3 digits... but since the hours, minutes and seconds can never be more than 2 digits -- and most often ARE 2 digits -- it would be helpful for those 3 specific fields.
The reason is that when 10 seconds becomes 9 seconds, everything moves. When 10 minutes becomes 9 minutes, same thing.
Just having 10 become 09 instead of 9 would make everything look a lot better, and behave more professionally (I find).
BONUS: If we can change the color of the "0" that gets added to the single digit, that would be even better (we could make it slightly darker, for a nice effect).
But just having 01, 02, 03 instead of 1, 2, 3 would be a great help.


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Eric Fisher becomes one of the most unlikely first overall picks in NFL draft history
In the high school class of 2009, Rivals.com ranked 95 offensive tackles. Eric Fisher wasn't one of them.
On Thursday night, he was the first overall selection of the NFL draft, by the Kansas City Chiefs.
Fisher was a two-star, unranked recruit. He was skinny offensive tackle (Rivals listed him at 260 pounds, but Fisher said he was 230) who had scholarship offers from Central Michigan and Eastern Michigan, and that's it. He said at the combine he talked to Michigan State and Purdue about walking on and "neither of them really wanted anything to do with me."
He played in the MAC, which that has never had a player drafted higher than No. 7 overall, the spot Marshall quarterback Byron Leftwich was selected. Every football fan knew about Andrew Luck, Cam Newton, Sam Bradford and Matthew Stafford before they were top overall picks. How many of you have ever seen Fisher play a game? OK, Central Michigan fans can put your hands down. Fans of other MAC teams and everyone who was snowed in when CMU played in the Little Caesars Pizza Bowl last December can too. Yep, not too many of you.
[Related: Pros and cons of No. 1 NFL draft pick Eric Fisher]
Most top NFL picks are stars well before they're drafted. Fisher might have been able to walk through Times Square to the draft and not be recognized.
The last small school non-quarterback to go first overall was Ed "Too Tall" Jones of Tennessee State in 1974. Only three other offensive linemen have ever gone first overall in the NFL draft, and they went to football factories USC, Ohio State and Michigan.
There was no way to see this coming years ago when Fisher was ignored by almost every FBS school. There was no way of seeing it coming a little more than a year ago when he was just a third-team all-MAC selection as a junior. It didn't seem possible when he failed to make even one first-team All-American squad as a senior, though that was mostly because few voters knew about him.
In many ways Fisher, who couldn't get a Big Ten team to even show interest in him as a walk-on, is the most unique first overall pick in NFL draft history.
"Hey, it doesn't matter where you start, it's where you end up," Fisher said at the combine. "That's a big thing I take to heart."
Adding to the unusual nature of the pick, it wasn't widely reported Fisher would be the top pick until just a few hours before the draft, a rarity during an era in which the No. 1 pick is usually well known weeks in advance. He apparently beat out Texas A&M offensive tackle Luke Joeckel in the Chiefs' draft room. He'll now protect new Chiefs quarterback Alex Smith, who in a weird twist was protected by 49ers left tackle and fellow former Central Michigan player Joe Staley in his last job.
Fisher gradually got better in college. The 70 pounds he put on obviously helped. He opened eyes at the Senior Bowl and worked his way up to be the first overall pick of the draft. Fisher deserved to get drafted first overall. He's strong, agile and should be a good player for years. It's just that his path to being the top pick is unprecedented.
Pick an unranked two-star MAC offensive tackle recruit from this year's high school class, or scan the third-team all-MAC squad for a lineman and project them to be the first overall pick of the NFL draft someday. Better yet, don't bother. Fisher's story will likely never be repeated again.
"I can't even process what's happening right now," Fisher told ESPN right after he was drafted. "This is a dream come true. The fact that I was the No. 1 pick, I can't understand what's going on right now. But what an honor."
More NFL draft coverage on Yahoo! Sports:
• Chiefs take Eric Fisher with top pick in NFL draft
• Photos: Biggest first-round NFL draft busts
• Photos: Worst-dressed NFL draft picks of all time


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Sounds at the heart of the Mediterranean
Paolo Petrocelli, founder of EMMA for Peace, reports on two musical events in Malta that promoted the work of charities protecting refugees in the region
'You can't make good music using just white keys. And you can't make good music using just black keys. If you want to make good music, you have to use black and white keys. Music is life.'
This powerful statement came from a young migrant from Ghana speaking in the middle of a concert organised by EMMA for Peace, Malta Philharmonic Orchestra and Malta Youth Orchestra, which took place on 1 February at the Robert Samut Hall in Floriana (Malta). It was the final event of Sounds at the heart of the Mediterranean, a joint project of the Office of the United Nations High Commissioner for Refugees (UNHCR), Foundation for Shelter and Support to Migrants and Junior Chamber International to support young refugees of the Mediterranean.
The Mediterranean is one of the busiest seaways in the world, as well as being a dangerous frontier for asylum seekers en route to southern Europe. Today, hundreds of thousands of migrants live in refugees camps after having lost everything: their homes, their loved ones, their dignity and their hope.
Most of the time, efforts of concerned organizations concentrate mainly on covering basic needs like food, medicines and warm clothing, while moral and psychological support is very lacking. EMMA for Peace's mission is to help large international organisations bring added value to their aid programs. Through music, education, arts and culture we are hoping to create a common territory for many young refugees: a world in which they will discover the importance of listening to each other, communicating and working together to express themselves and have their hopes and voices heard by the world; a world in which they can live in harmony with themselves and with others.
Musicians from the Youth Orchestra percussion section joined forces with young migrants for a powerful musical experience led by MPO principal percussionist Daniel Cauchi. Three weeks of workshops on improvisation, collective lyric-writing and musical composition culminated in a public performance that attracted a diverse audience of young people, professional musicians, migrants, diplomats and representatives from international organizations. These included Ms Chiara Milani, Junior Chamber International World President 2013, and Jon Hoisaete, Head of UNHCR Office in Malta.
On 31 January at Teatru Manoel in Valletta (Malta), Malta Philharmonic Orchestra in collaboration with EMMA for Peace presented a solidarity concert of Italian Opera, featuring acclaimed Maltese soprano Miriam Cauchi under the direction of Greek conductor Michalis Economou. There was also a pre-concert talk about the situation of refugees and EMMA for Peace's educational activities in Malta.
It was exciting and moving for me to see the Maltese population demonstrating its attention and support for the project by participating in both concerts with enthusiasm and warmth. Patronage came from the President of the Republic of Malta, His Excellency Dr George Abela, Chairman of the Malta Philharmonic Orchestra Mr. Sigmund Mifsud and Greek conductor Michalis Economou among others.
The long musical journey towards understanding and peace continues.
Paolo Petrocelli, Founder & President, EMMA for Peace
- Article Type: | Blog |


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[Wyeth Pharmaceuticals, Inc.]
Rx only
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Zosyn (piperacillin and tazobactam) injection and other antibacterial drugs, Zosyn (piperacillin and tazobactam) should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.
ZOSYN® (piperacillin and tazobactam injection) in Galaxy® Containers (PL 2040 Plastic) is a sterile injectable antibacterial combination product consisting of the semisynthetic antibiotic piperacillin sodium and the β-lactamase inhibitor tazobactam sodium for intravenous administration.
Piperacillin sodium is derived from D(-)-α-aminobenzyl-penicillin. The chemical name of piperacillin sodium is sodium (2S,5R,6R)-6-[(R)-2-(4-ethyl-2,3-dioxo-1-piperazine-carboxamido)-2-phenylacetamido]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylate. The chemical formula is C23H26N5NaO7S and the molecular weight is 539.5. The chemical structure of piperacillin sodium is:
Tazobactam sodium, a derivative of the penicillin nucleus, is a penicillanic acid sulfone. Its chemical name is sodium (2S,3S,5R)-3-methyl-7-oxo-3-(1H-1,2,3-triazol-1-ylmethyl)-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylate-4,4-dioxide. The chemical formula is C10H11N4NaO5S and the molecular weight is 322.3. The chemical structure of tazobactam sodium is:
ZOSYN in the Galaxy Container (PL 2040 Plastic) is a frozen iso-osmotic sterile non-pyrogenic premixed solution. The components and dosage formulations are given in the table below:
|Dosage Formulations
|2.25 g/50 mL
|3.375 g/50 mL
|4.5 g/100 mL
*Piperacillin and tazobactam are present in the formulation as sodium salts. Dextrose hydrous, sodium citrate dihydrate, and edetate disodium dihydrate amounts are approximate.
|active ingredient
|2 g
|3 g
|4 g
|β-lactamase inhibitor
|250 mg
|375 mg
|500 mg
|Dextrose Hydrous
|osmolality adjusting agent
|1 g
|350 mg
|2 g
|Sodium Citrate Dihydrate
|buffering agent
|100 mg
|150 mg
|200 mg
|Edetate Disodium Dihydrate
|metal chelator
|0.5 mg
|0.75 mg
|1 mg
|Water for Injection
|q.s. 50 mL
|q.s. 50 mL
|q.s. 100 mL
The pH has been adjusted between 5.5 to 6.8 with sodium bicarbonate and hydrochloric acid.
The solution is intended for intravenous use only.
The plastic container is fabricated from a specially designed multilayer plastic, PL 2040. Solutions are in contact with the polyethylene layer of this container and can leach out certain chemical components of the plastic in very small amounts within the expiration period. The suitability of the plastic has been confirmed in tests in animals according to the USP biological tests for plastic containers, as well as by tissue culture toxicity studies.
The approximate total sodium content for ZOSYN in Galaxy Containers is 5.58 mEq (128 mg) per 50 mL in the 2.25 g dose, 8.38 mEq (192 mg) per 50 mL in the 3.375 g dose, and 11.17 mEq (256 mg) per 100 mL in the 4.5 g dose.
Peak plasma concentrations of piperacillin and tazobactam are attained immediately after completion of an intravenous infusion of ZOSYN. Piperacillin plasma concentrations, following a 30-minute infusion of ZOSYN, were similar to those attained when equivalent doses of piperacillin were administered alone, with mean peak plasma concentrations of approximately 134 μg/mL, 242 μg/mL, and 298 μg/mL for the 2.25 g, 3.375 g, and 4.5 g ZOSYN (piperacillin/tazobactam) doses, respectively. The corresponding mean peak plasma concentrations of tazobactam were 15 μg/mL, 24 μg/mL, and 34 μg/mL, respectively.
Following a 30-minute I.V. infusion of 3.375 g ZOSYN every 6 hours, steady-state plasma concentrations of piperacillin and tazobactam were similar to those attained after the first dose. In like manner, steady-state plasma concentrations were not different from those attained after the first dose when 2.25 g or 4.5 g doses of ZOSYN were administered via 30-minute infusions every 6 hours. Steady-state plasma concentrations after 30-minute infusions every 6 hours are provided in Table 2.
Following single or multiple ZOSYN doses to healthy subjects, the plasma half-life of piperacillin and of tazobactam ranged from 0.7 to 1.2 hours and was unaffected by dose or duration of infusion.
Piperacillin is metabolized to a minor microbiologically active desethyl metabolite. Tazobactam is metabolized to a single metabolite that lacks pharmacological and antibacterial activities. Both piperacillin and tazobactam are eliminated via the kidney by glomerular filtration and tubular secretion. Piperacillin is excreted rapidly as unchanged drug with 68% of the administered dose excreted in the urine. Tazobactam and its metabolite are eliminated primarily by renal excretion with 80% of the administered dose excreted as unchanged drug and the remainder as the single metabolite. Piperacillin, tazobactam, and desethyl piperacillin are also secreted into the bile.
Both piperacillin and tazobactam are approximately 30% bound to plasma proteins. The protein binding of either piperacillin or tazobactam is unaffected by the presence of the other compound. Protein binding of the tazobactam metabolite is negligible.
Piperacillin and tazobactam are widely distributed into tissues and body fluids including intestinal mucosa, gallbladder, lung, female reproductive tissues (uterus, ovary and fallopian tube), interstitial fluid, and bile. Mean tissue concentrations are generally 50% to 100% of those in plasma. Distribution of piperacillin and tazobactam into cerebrospinal fluid is low in subjects with non-inflamed meninges, as with other penicillins.
After the administration of single doses of piperacillin/tazobactam to subjects with renal impairment, the half-life of piperacillin and of tazobactam increases with decreasing creatinine clearance. At creatinine clearance below 20 mL/min, the increase in half-life is twofold for piperacillin and fourfold for tazobactam compared to subjects with normal renal function. Dosage adjustments for ZOSYN are recommended when creatinine clearance is below 40 mL/min in patients receiving the usual recommended daily dose of ZOSYN. (See DOSAGE AND ADMINISTRATION section for specific recommendations for the treatment of patients with renal insufficiency.)
Hemodialysis removes 30 to 40% of a piperacillin/tazobactam dose with an additional 5% of the tazobactam dose removed as the tazobactam metabolite. Peritoneal dialysis removes approximately 6% and 21% of the piperacillin and tazobactam doses, respectively, with up to 16% of the tazobactam dose removed as the tazobactam metabolite. For dosage recommendations for patients undergoing hemodialysis, see DOSAGE AND ADMINISTRATION section.
The half-life of piperacillin and of tazobactam increases by approximately 25% and 18%, respectively, in patients with hepatic cirrhosis compared to healthy subjects. However, this difference does not warrant dosage adjustment of ZOSYN due to hepatic cirrhosis.
|Plasma Concentrations** (μg/mL)
|No. of
Evaluable Subjects
|30 min
|1 hr
|2 hr
|3 hr
|4 hr
|6 hr
Numbers in parentheses are coefficients of variation (CV%).
|2.25 g
|134 (14)
|57 (14)
|17.1 (23)
|5.2 (32)
|2.5 (35)
|0.9 (14)b
|131 (14)
|3.375 g
|242 (12)
|106 (8)
|34.6 (20)
|11.5 (19)
|5.1 (22)
|1.0 (10)
|242 (10)
|4.5 g
|298 (14)
|141 (19)
|46.6 (28)
|16.4 (29)
|6.9 (29)
|1.4 (30)
|322 (16)
|Plasma Concentrations** (μg/mL)
|No. of
|30 min
|1 hr
|2 hr
|3 hr
|4 hr
|6 hr
|2.25 g
|14.8 (14)
|7.2 (22)
|2.6 (30)
|1.1 (35)
|0.7 (6)c
|16.0 (21)
|3.375 g
|24.2 (14)
|10.7 (7)
|4.0 (18)
|1.4 (21)
|0.7 (16)b
|25.0 (8)
|4.5 g
|33.8 (15)
|17.3 (16)
|6.8 (24)
|2.8 (25)
|1.3 (30)
|39.8 (15)
Piperacillin and tazobactam pharmacokinetics were studied in pediatric patients 2 months of age and older. The clearance of both compounds is slower in the younger patients compared to older children and adults.
In a population PK analysis, estimated clearance for 9 month-old to 12 year-old patients was comparable to adults, with a population mean (SE) value of 5.64 (0.34) mL/min/kg. The piperacillin clearance estimate is 80% of this value for pediatric patients 2 - 9 months old. In patients younger than 2 months of age, clearance of piperacillin is slower compared to older children; however, it is not adequately characterized for dosing recommendations. The population mean (SE) for piperacillin distribution volume is 0.243 (0.011) L/kg and is independent of age.
Piperacillin sodium exerts bactericidal activity by inhibiting septum formation and cell wall synthesis of susceptible bacteria. In vitro, piperacillin is active against a variety of gram-positive and gram-negative aerobic and anaerobic bacteria. Tazobactam sodium has little clinically relevant in vitro activity against bacteria due to its reduced affinity to penicillin-binding proteins. It is, however, a β-lactamase inhibitor of the Richmond-Sykes class III (Bush class 2b & 2b') penicillinases and cephalosporinases. It varies in its ability to inhibit class II and IV (2a & 4) penicillinases. Tazobactam does not induce chromosomally-mediated β-lactamases at tazobactam concentrations achieved with the recommended dosage regimen.
Piperacillin/tazobactam has been shown to be active against most strains of the following microorganisms both in vitro and in clinical infections as described in the INDICATIONS AND USAGE section.
Staphylococcus aureus (excluding methicillin and oxacillin-resistant isolates)
Acinetobacter baumanii
Escherichia coli
Haemophilus influenzae (excluding β-lactamase negative, ampicillin-resistant isolates)
Klebsiella pneumoniae
Pseudomonas aeruginosa (given in combination with an aminoglycoside to which the isolate is susceptible)
Bacteroides fragilis group (B. fragilis, B. ovatus, B. thetaiotaomicron, and B. vulgatus)
The following in vitro data are available, but their clinical significance is unknown.
At least 90% of the following microorganisms exhibit in vitro minimum inhibitory concentration (MIC) less than or equal to the susceptible breakpoint for piperacillin/tazobactam. However, the safety and effectiveness of piperacillin/tazobactam in treating clinical infections due to these bacteria have not been established in adequate and well-controlled clinical trials.
Enterococcus faecalis (ampicillin or penicillin-susceptible isolates only)
Staphylococcus epidermidis (excluding methicillin and oxacillin-resistant isolates)
Streptococcus agalactiae†
Streptococcus pneumoniae† (penicillin-susceptible isolates only)
Streptococcus pyogenes†
Viridans group streptococci†
†These are not β-lactamase producing bacteria and, therefore, are susceptible to piperacillin alone.
As is recommended with all antimicrobials, the results of in vitro susceptibility tests, when available, should be provided to the physician as periodic reports, which describe the susceptibility profile of nosocomial and community acquired pathogens. These reports should aid the physician in selecting the most effective antimicrobial.
Quantitative methods are used to determine antimicrobial minimum inhibitory concentrations (MICs). These MICs provide estimates of the susceptibility of bacteria to antimicrobial compounds. The MICs should be determined using a standardized procedure. Standardized procedures are based on a dilution method (broth or agar) or equivalent with standardized inoculum concentrations and standardized concentrations of piperacillin and tazobactam powders. 1,2 MIC values should be determined using serial dilutions of piperacillin combined with a fixed concentration of 4 μg/mL tazobactam. The MIC values obtained should be interpreted according to criteria provided in Table 3.
Quantitative methods that require measurement of zone diameters also provide reproducible estimates of the susceptibility of bacteria to antimicrobial compounds. One such standardized procedure 1,3 requires the use of standardized inoculum concentrations. This procedure uses paper disks impregnated with 100 μg of piperacillin and 10 μg of tazobactam to test the susceptibility of microorganisms to piperacillin/tazobactam. The disk diffusion interpreted criteria are provided in Table 3.
For anaerobic bacteria, the susceptibility to piperacillin/tazobactam can be determined by the reference agar dilution method. 4
a: These interpretive criteria for Haemophilus influenzae are applicable only to tests performed using Haemophilus Test Medium inoculated with a direct colony suspension and incubated at 35°C in ambient air for 20 to 24 hours.
|Susceptibility Test Result Interpretive Criteria
|Minimal Inhibitory Concentration
(MIC in μg/mL)
|Disk Diffusion
(Zone Diameter in mm)
|Enterobacteriaceae and Acinetobacter baumanii
|≤ 16
|32 - 64
|≥ 128
|≥ 21
|18 - 20
|≤ 17
|Haemophilus influenzae a
|≤ 1
|≥ 2
|Pseudomonas aeruginosa
|≤ 64
|≥ 128
|≥ 18
|≤ 17
|Staphylococcus aureus
|≤ 8
|≥ 16
|≥ 20
|≤ 19
|Bacteroides fragilis group
|≤ 32
|≥ 128
A report of S ("Susceptible") indicates that the pathogen is likely to be inhibited if the antimicrobial compound in the blood reaches the concentrations usually achievable. A report of I ("Intermediate") indicates that the results should be considered equivocal, and, if the microorganism is not fully susceptible to alternative, clinically feasible drugs, the test should be repeated. This category implies possible clinical applicability in body sites where the drug is physiologically concentrated or in situations where high dosage of drug can be used. This category also provides a buffer zone, which prevents small, uncontrolled technical factors from causing major discrepancies in interpretation. A report of R ("Resistant") indicates that the pathogen is not likely to be inhibited if the antimicrobial compound in the blood reaches the concentrations usually achievable; other therapy should be considered.
Standardized susceptibility test procedures require the use of laboratory control microorganisms to control the technical aspects of the procedures. 1,2,3,4 Standard piperacillin/tazobactam powder should provide the following ranges of values noted in Table 4. Quality control microorganisms are specific strains of microorganisms with intrinsic biological properties relating to resistance mechanisms and their genetic expression within the microorganism; the specific strains used for microbiological quality control are not clinically significant.
|Acceptable Quality Control Ranges
QC Strain
|Minimum Inhibitory
Range (MIC in μg/mL)
|Disk Diffusion
Zone Diameter Ranges in mm
a: This quality control range for Haemophilus influenzae is applicable only to tests performed using Haemophilus Test Medium inoculated with a direct colony suspension and incubated at 35°C in ambient air for 20 to 24 hours.
Escherichia coli
|1 - 4
|24 - 30
Escherichia coli
|0.5 - 2
|24 - 30
Pseudomonas aeruginosa
|1 - 8
|25 - 33
Haemophilus influenzaea
|0.06 - 0.5
Staphylococcus aureus
|0.25 - 2
Staphylococcus aureus
|27 - 36
Bacteroides fragilis
|0.12 - 0.5
Bacteroides thetaiotaomicron
|4 - 16
ZOSYN is indicated for the treatment of patients with moderate to severe infections caused by piperacillin-resistant, piperacillin/tazobactam-susceptible, β-lactamase producing strains of the designated microorganisms in the specified conditions listed below:
Appendicitis (complicated by rupture or abscess) and peritonitis caused by piperacillin-resistant, β-lactamase producing strains of Escherichia coli or the following members of the Bacteroides fragilis group: B. fragilis, B. ovatus, B. thetaiotaomicron , or B. vulgatus. The individual members of this group were studied in less than 10 cases.
Uncomplicated and complicated skin and skin structure infections, including cellulitis, cutaneous abscesses and ischemic/diabetic foot infections caused by piperacillin-resistant, β-lactamase producing strains of Staphylococcus aureus.
Postpartum endometritis or pelvic inflammatory disease caused by piperacillin-resistant, β-lactamase producing strains of Escherichia coli.
Community-acquired pneumonia (moderate severity only) caused by piperacillin-resistant, β-lactamase producing strains of Haemophilus influenzae.
Nosocomial pneumonia (moderate to severe) caused by piperacillin-resistant, β-lactamase producing strains of Staphylococcus aureus and by piperacillin/tazobactam-susceptible Acinetobacter baumanii, Haemophilus influenzae, Klebsiella pneumoniae, and Pseudomonas aeruginosa . (Nosocomial pneumonia caused by P. aeruginosa should be treated in combination with an aminoglycoside.) (See DOSAGE AND ADMINISTRATION.)
ZOSYN is indicated only for the specified conditions listed above. Infections caused by piperacillin-susceptible organisms, for which piperacillin has been shown to be effective, are also amenable to ZOSYN treatment due to its piperacillin content. The tazobactam component of this combination product does not decrease the activity of the piperacillin component against piperacillin-susceptible organisms. Therefore, the treatment of mixed infections caused by piperacillin-susceptible organisms and piperacillin-resistant, β-lactamase producing organisms susceptible to ZOSYN should not require the addition of another antibiotic. (See DOSAGE AND ADMINISTRATION.)
ZOSYN is useful as presumptive therapy in the indicated conditions prior to the identification of causative organisms because of its broad spectrum of bactericidal activity against gram-positiveand gram-negative aerobic and anaerobic organisms.
Appropriate cultures should usually be performed before initiating antimicrobial treatment in order to isolate and identify the organisms causing infection and to determine their susceptibility to ZOSYN. Antimicrobial therapy should be adjusted, if appropriate, once the results of culture(s) and antimicrobial susceptibility testing are known.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Zosyn (piperacillin and tazobactam) injection and other antibacterial drugs, Zosyn (piperacillin and tazobactam) should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
ZOSYN is contraindicated in patients with a history of allergic reactions to any of the penicillins, cephalosporins, orβ-lactamase inhibitors.
Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including ZOSYN, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatmentof C. difficile, and surgical evaluation should be instituted as clinically indicated.
Bleeding manifestations have occurred in some patients receiving β-lactam antibiotics, including piperacillin. These reactions have sometimes been associated with abnormalities of coagulation tests such as clotting time, platelet aggregation, and prothrombin time, and are more likely to occur in patients with renal failure. If bleeding manifestations occur, ZOSYN should be discontinued and appropriate therapy instituted.
The possibility of the emergence of resistant organisms that might cause superinfections should be kept in mind. If this occurs, appropriate measures should be taken.
As with other penicillins, patients may experience neuromuscular excitability or convulsions if higher than recommended doses are given intravenously (particularly in the presence of renal failure).
ZOSYN in Galaxy Containers contains a monosodium salt of piperacillin, a monosodium salt of tazobactam, and sodium from other formulation components. The approximate total sodium content for ZOSYN in Galaxy Containers is 5.58 mEq (128 mg) per 50 mL in the 2.25 g dose, 8.38 mEq (192 mg) per 50 mL in the 3.375 g dose, and 11.17 mEq (256 mg) per 100 mL in the 4.5 g dose. This should be considered when treating patients requiring restricted salt intake. Periodic electrolyte determinations should be performed in patients with low potassium reserves, and the possibility of hypokalemia should be kept in mind with patients who have potentially low potassium reserves and who are receiving cytotoxic therapy or diuretics. As with other semisynthetic penicillins, piperacillin therapy has been associated with an increased incidence of fever and rash in cystic fibrosis patients.
In patients with creatinine clearance ≤ 40 mL/min and dialysis patients (hemodialysis and CAPD), the intravenous dose should be adjusted to the degree of renal function impairment. (See DOSAGE AND ADMINISTRATION.)
Prescribing Zosyn (piperacillin and tazobactam) in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of development of drug-resistant bacteria.
Patients should be counseled that antibacterial drugs including Zosyn should only be used to treat bacterial infections. They do not treat viral infections (e.g., the common cold). When Zosyn is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may (1) decrease the effectiveness of the immediate treatment and (2) increase the likelihood that bacteria will develop resistance and will not be treatable by Zosyn or other antibacterial drugs in the future.
Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools (with or without stomach cramps and fever) even as late as two or more months after having taken the last dose of the antibiotic. If this occurs, patients should contact their physician as soon as possible.
Periodic assessment of hematopoietic function should be performed, especially with prolonged therapy, ie, ≥ 21 days. (See ADVERSE REACTIONS, Adverse Laboratory Events.)
The mixing of beta-lactam antibiotics with aminoglycosides in vitro can result in substantial inactivation of the aminoglycoside. However, amikacin and gentamicin have been shown to be compatible in vitro with reformulated Zosyn containing EDTA supplied in vials or bulk pharmacy containers in certain diluents at specific concentrations for a simultaneous Y-site infusion. (See DOSAGE AND ADMINISTRATION.) Reformulated Zosyn containing EDTA is not compatible with tobramycin for simultaneous coadministration via Y-site infusion.
The inactivation of aminoglycosides in the presence of penicillin-class drugs has been recognized. It has been postulated that penicillin-aminoglycoside complexes form; these complexes are microbiologically inactive and of unknown toxicity. Sequential administration of Zosyn with tobramycin to patients with normal renal function and mild to moderate renal impairment has been shown to modestly decrease serum concentrations of tobramycin but does not significantly affect tobramycin pharmacokinetics. When aminoglycosides are administered in combination with piperacillin to patients with end-stage renal disease requiring hemodialysis, the concentrations of the aminoglycosides (especially tobramycin) may be significantly altered and should be monitored. Since aminoglycosides are not equally susceptible to inactivation by piperacillin, consideration should be given to the choice of the aminoglycoside when administered in combination with piperacillin to these patients.
Probenecid administered concomitantly with ZOSYN prolongs the half-life of piperacillin by 21% and of tazobactam by 71%.
No pharmacokinetic interactions have been noted between ZOSYN and vancomycin.
Coagulation parameters should be tested more frequently and monitored regularly during simultaneous administration of high doses of heparin, oral anticoagulants, or other drugs that may affect the blood coagulation system or the thrombocyte function.
Piperacillin when used concomitantly with vecuronium has been implicated in the prolongation of the neuromuscular blockade of vecuronium. ZOSYN could produce the same phenomenon if given along with vecuronium. Due to their similar mechanism of action, it is expected that the neuromuscular blockade produced by any of the non-depolarizing muscle relaxants could be prolonged in the presence of piperacillin. (See package insert for vecuronium bromide.)
Limited data suggests that coadministration of methotrexate and piperacillin may reduce the clearance of methotrexate due to competition for renal secretion. The impact of tazobactam on the elimination of methotrexate has not been evaluated. If concurrent therapy is necessary, serum concentrations of methotrexate as well as the signs and symptoms of methotrexate toxicity should be frequently monitored.
As with other penicillins, the administration of ZOSYN may result in a false-positive reaction for glucose in the urine using a copper-reduction method (CLINITEST®). It is recommended that glucose tests based on enzymatic glucose oxidase reactions (such as DIASTIX® or TES-TAPE®) be used.
There have been reports of positive test results using the Bio-Rad Laboratories Platelia Aspergillus EIA test in patients receiving piperacillin/tazobactam injection who were subsequently found to be free of Aspergillus infection. Cross-reactions with non-Aspergillus polysaccharides and polyfuranoses with the Bio-Rad Laboratories Platelia Aspergillus EIA test have been reported.
Therefore, positive test results in patients receiving piperacillin/tazobactam should be interpreted cautiously and confirmed by other diagnostic methods.
Long-term carcinogenicity studies in animals have not been conducted with piperacillin/tazobactam, piperacillin, or tazobactam.
Piperacillin/tazobactam was negative in microbial mutagenicity assays at concentrations up to 14.84/1.86 μg/plate. Piperacillin/tazobactam was negative in the unscheduled DNA synthesis (UDS) test at concentrations up to 5689/711 μg/mL. Piperacillin/tazobactam was negative in a mammalian point mutation (Chinese hamster ovary cell HPRT) assay at concentrations up to 8000/1000 μg/mL. Piperacillin/tazobactam was negative in a mammalian cell (BALB/c-3T3) transformation assay at concentrations up to 8/1 μg/mL. In vivo, piperacillin/tazobactam did not induce chromosomal aberrations in rats dosed I.V. with 1500/187.5 mg/kg; this dose is similar to the maximum recommended human daily dose on a body-surface-area basis (mg/m2).
Piperacillin was negative in microbial mutagenicity assays at concentrations up to 50 μg/plate. There was no DNA damage in bacteria (Rec assay) exposed to piperacillin at concentrations up to 200 μg/disk. Piperacillin was negative in the UDS test at concentrations up to 10,000 μg/mL. In a mammalian point mutation (mouse lymphoma cells) assay, piperacillin was positive at concentrations ≥2500 μg/mL. Piperacillin was negative in a cell (BALB/c-3T3) transformation assay at concentrations up to 3000 μg/mL. In vivo, piperacillin did not induce chromosomal aberrations in mice at I.V. doses up to 2000 mg/kg/day or rats at I.V. doses up to 1500 mg/kg/day. These doses are half (mice) or similar (rats) to the maximum recommended human daily dose based on body-surface area (mg/m2). In another in vivo test, there was no dominant lethal effect when piperacillin was administered to rats at I.V. doses up to 2000 mg/kg/day, which is similar to the maximum recommended human daily dose based on body-surface area (mg/m2). When mice were administered piperacillin at I.V. doses up to 2000 mg/kg/day, which is half the maximum recommended human daily dose based on body-surface area (mg/m2), urine from these animals was not mutagenic when tested in a microbial mutagenicity assay. Bacteria injected into the peritoneal cavity of mice administered piperacillin at I.V. doses up to 2000 mg/kg/day did not show increased mutation frequencies.
Tazobactam was negative in microbial mutagenicity assays at concentrations up to 333 μg/plate. Tazobactam was negative in the UDS test at concentrations up to 2000 μg/mL. Tazobactam was negative in a mammalian point mutation (Chinese hamster ovary cell HPRT) assay at concentrations up to 5000 μg/mL. In another mammalian point mutation (mouse lymphoma cells) assay, tazobactam was positive at concentrations ≥3000 μg/mL. Tazobactam was negative in a cell (BALB/c-3T3) transformation assay at concentrations up to 900 μg/mL. In an in vitro cytogenetics (Chinese hamster lung cells) assay, tazobactam was negative at concentrations up to 3000 μg/mL. In vivo, tazobactam did not induce chromosomal aberrations in rats at I.V. doses up to 5000 mg/kg, which is 23 times the maximum recommended human daily dose based on body-surface area (mg/m2).
Reproduction studies have been performed in rats and have revealed no evidence of impaired fertility due to piperacillin/tazobactam administered up to a dose which is similar to the maximum recommended human daily dose based on body-surface area (mg/m2).
Teratology studies have been performed in mice and rats and have revealed no evidence of harm to the fetus due to piperacillin/tazobactam administered up to a dose which is 1 to 2 times and 2 to 3 times the human dose of piperacillin and tazobactam, respectively, based on body-surface area (mg/m2).
Piperacillin and tazobactam cross the placenta in humans.
Reproduction and teratology studies have been performed in mice and rats and have revealed no evidence of impaired fertility or harm to the fetus due to piperacillin administered up to a dose which is half (mice) or similar (rats) to the maximum recommended human daily dose based on body-surface area (mg/m2).
Reproduction studies have been performed in rats and have revealed no evidence of impaired fertility due to tazobactam administered at doses up to 3 times the maximum recommended human daily dose based on body-surface area (mg/m2).
Teratology studies have been performed in mice and rats and have revealed no evidence of harm to the fetus due to tazobactam administered at doses up to 6 and 14 times, respectively, the human dose based on body-surface area (mg/m2). In rats, tazobactam crosses the placenta. Concentrations in the fetus are less than or equal to 10% of those found in maternal plasma.
There are, however, no adequate and well-controlled studies with the piperacillin/tazobactam combination or with piperacillin or tazobactam alone in pregnant women. Because animal reproduction studies are not always predictive of the human response, this drug should be used during pregnancy only if clearly needed.
Piperacillin is excreted in low concentrations in human milk; tazobactam concentrations in human milk have not been studied. Caution should be exercised when ZOSYN is administered to a nursing woman.
Use of Zosyn in pediatric patients 2 months of age or older with appendicitis and/or peritonitis is supported by evidence from well-controlled studies and pharmacokinetic studies in adults and in pediatric patients. This includes a prospective, randomized, comparative, open-label clinical trial with 542 pediatric patients 2-12 years of age with complicated intra-abdominal infections, in which 273 pediatric patients received piperacillin/tazobactam. Safety and efficacy in pediatric patients less than 2 months of age have not been established (see CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION).
There are no dosage recommendations for Zosyn in pediatric patients with impaired renal function.
Patients over 65 years are not at an increased risk of developing adverse effects solely because of age. However, dosage should be adjusted in the presence of renal insufficiency. (See DOSAGE AND ADMINISTRATION.)
In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
The approximate total sodium content for ZOSYN in Galaxy Containers is 5.58 mEq (128 mg) per 50 mL in the 2.25 g dose, 8.38 mEq (192 mg) per 50 mL in the 3.375 g dose, and 11.17 mEq (256 mg) per 100 mL in the 4.5 g dose. At the usual recommended doses, patients would receive approximately 790 to 1050 mg/day (33.5 to 44.6 mEq) of sodium. The geriatric population may respond with a blunted natriuresis to salt loading. This may be clinically important with regard to such diseases as congestive heart failure.
This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.
During the initial clinical investigations, 2621 patients worldwide were treated with ZOSYN in phase 3 trials. In the key North American clinical trials (n=830 patients), 90% of the adverse events reported were mild to moderate in severity and transient in nature. However, in 3.2% of the patients treated worldwide, ZOSYN was discontinued because of adverse events primarily involving the skin (1.3%), including rash and pruritus; the gastrointestinal system (0.9%), including diarrhea, nausea, and vomiting; and allergic reactions (0.5%).
Adverse local reactions that were reported, irrespective of relationship to therapy with ZOSYN, were phlebitis (1.3%), injection site reaction (0.5%), pain (0.2%), inflammation (0.2%), thrombophlebitis (0.2%), and edema (0.1%).
Based on patients from the North American trials (n=1063), the events with the highest incidence in patients, irrespective of relationship to ZOSYN therapy, were diarrhea (11.3%); headache (7.7%); constipation (7.7%); nausea (6.9%); insomnia (6.6%); rash (4.2%), including maculopapular, bullous, urticarial, and eczematoid; vomiting (3.3%); dyspepsia (3.3%); pruritus (3.1%); stool changes (2.4%); fever (2.4%); agitation (2.1%); pain (1.7%); moniliasis (1.6%); hypertension (1.6%); dizziness (1.4%); abdominal pain (1.3%); chest pain (1.3%); edema (1.2%); anxiety (1.2%); rhinitis (1.2%); and dyspnea (1.1%).
Additional adverse systemic clinical events reported in 1.0% or less of the patients in the initial North American trials are listed below within each body system.
Autonomic nervous system—hypotension, ileus, syncope
Body as a whole—rigors, back pain, malaise
Cardiovascular—tachycardia, including supraventricular and ventricular; bradycardia; arrhythmia, including atrial fibrillation, ventricular fibrillation, cardiac arrest, cardiac failure, circulatory failure, myocardial infarction
Central nervous system—tremor, convulsions, vertigo
Gastrointestinal—melena, flatulence, hemorrhage, gastritis, hiccough, ulcerative stomatitis
Pseudomembranous colitis was reported in one patient during the clinical trials. The onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment. (See WARNINGS.)
Hearing and Vestibular System—tinnitus
Metabolic and Nutritional—symptomatic hypoglycemia, thirst
Musculoskeletal —myalgia, arthralgia
Platelets, Bleeding, Clotting—mesenteric embolism, purpura, epistaxis, pulmonary embolism (See PRECAUTIONS, General.)
Psychiatric —confusion, hallucination, depression
Reproductive, Female—leukorrhea, vaginitis
Respiratory —pharyngitis, pulmonary edema, bronchospasm, coughing
Skin and Appendages—genital pruritus, diaphoresis
Special senses—taste perversion
Urinary—retention, dysuria, oliguria, hematuria, incontinence
Vision —photophobia
Vascular (extracardiac)—flushing
In a completed study of nosocomial lower respiratory tract infections, 222 patients were treated with ZOSYN in a dosing regimen of 4.5 g every 6 hours in combination with an aminoglycoside and 215 patients were treated with imipenem/cilastatin (500 mg/500 mg q6h) in combination with an aminoglycoside. In this trial, treatment-emergent adverse events were reported by 402 patients, 204 (91.9%) in the piperacillin/tazobactam group and 198 (92.1%) in the imipenem/cilastatin group. Twenty-five (11.0%) patients in the piperacillin/tazobactam group and 14 (6.5%) in the imipenem/cilastatin group (p > 0.05) discontinued treatment due to an adverse event.
In this study of ZOSYN in combination with an aminoglycoside, adverse events that occurred in more than 1% of patients and were considered by the investigator to be drug-related were: diarrhea (17.6%), fever (2.7%), vomiting (2.7%), urinary tract infection (2.7%), rash (2.3%), abdominal pain (1.8%), generalized edema (1.8%), moniliasis (1.8%), nausea (1.8%), oral moniliasis (1.8%), BUN increased (1.8%), creatinine increased (1.8%), peripheral edema (1.8%), abdomen enlarged (1.4%), headache(1.4%), constipation (1.4%), liver function tests abnormal (1.4%), thrombocythemia (1.4%), excoriations (1.4%), and sweating (1.4%).
Drug-related adverse events reported in 1% or less of patients in the nosocomial pneumonia study of ZOSYN with an aminoglycoside were: acidosis, acute kidney failure, agitation, alkaline phosphatase increased, anemia, asthenia, atrial fibrillation, chest pain, CNS depression, colitis, confusion, convulsion, cough increased, thrombocytopenia, dehydration, depression, diplopia, drug level decreased, dry mouth, dyspepsia, dysphagia, dyspnea, dysuria, eosinophilia, fungal dermatitis, gastritis, glossitis, grand mal convulsion, hematuria, hyperglycemia, hypernatremia, hypertension, hypertonia, hyperventilation, hypochromic anemia, hypoglycemia, hypokalemia, hyponatremia, hypophosphatemia, hypoxia, ileus, injection site edema, injection site pain, injection site reaction, kidney function abnormal, leukocytosis, leukopenia, local reaction to procedure, melena, pain, prothrombin decreased, pruritus, respiratory disorder, SGOT increased, SGPT increased, sinus bradycardia, somnolence, stomatitis, stupor, tremor, tachycardia, ventricular extrasystoles, and ventricular tachycardia.
In a previous nosocomial pneumonia study conducted with a dosing regimen of 3.375 g given every 4 hours with an aminoglycoside, the following adverse events, irrespective of drug relationship, were observed: diarrhea (20%); constipation (8.4%); agitation (7.1%); nausea (5.8%); headache (4.5%); insomnia (4.5%); oral thrush (3.9%); erythematous rash (3.9%); anxiety (3.2%); fever (3.2%); pain (3.2%); pruritus (3.2%); hiccough (2.6%); vomiting (2.6%); dyspepsia (1.9%); edema (1.9%); fluid overload (1.9%); stool changes (1.9%); anorexia (1.3%); cardiac arrest (1.3%); confusion (1.3%); diaphoresis (1.3%); duodenal ulcer (1.3%); flatulence (1.3%); hypertension (1.3%); hypotension (1.3%); inflammation at injection site (1.3%); pleural effusion (1.3%); pneumothorax (1.3%); rash, not otherwise specified (1.3%); supraventricular tachycardia (1.3%); thrombophlebitis (1.3%); and urinary incontinence (1.3%).
Adverse events irrespective of drug relationship observed in 1% or less of patients in the above study with ZOSYN and an aminoglycoside included: aggressive reaction (combative), angina, asthenia, atelectasis, balanoposthitis, cerebrovascular accident, chest pain, conjunctivitis, deafness, dyspnea, earache, ecchymosis, fecal incontinence, gastric ulcer, gout, hemoptysis, hypoxia, pancreatitis, perineal irritation/pain, urinary tract infection with trichomonas, vitamin B12 deficiency anemia, xerosis, and yeast in urine.
Studies of Zosyn in pediatric patients suggest a similar safety profile to that seen in adults. In a prospective, randomized, comparative, open-label clinical trial of pediatric patients with severe intra-abdominal infections (including appendicitis and/or peritonitis), 273 patients were treated with Zosyn (112.5 mg/kg every 8 hours) and 269 patients were treated with cefotaxime (50 mg/kg) plus metronidazole (7.5 mg/kg) every 8 hours. In this trial, treatment-emergent adverse events were reported by 146 patients, 73 (26.7%) in the Zosyn group and 73 (27.1%) in the cefotaxime/metronidazole group. Six patients (2.2%) in the Zosyn group and 5 patients (1.9%) in the cefotaxime/metronidazole group discontinued due to an adverse event.
In this study, adverse events that were reported in more than 1% of patients, irrespective of relationship to therapy with ZOSYN were: diarrhea (7.0%), fever (4.8%), vomiting (3.7%), local reaction (3.3%), abscess (2.2%), sepsis (2.2%), abdominal pain (1.8%), infection (1.8%), bloody diarrhea (1.1%), pharyngitis (1.5%), constipation (1.1%) and SGOT increase (1.1%).
Adverse events reported in 1% or less of pediatric patients receiving Zosyn are consistent with adverse events reported in adults.
Additional controlled studies in pediatric patients showed a similar safety profile as that described above.
Additional adverse events reported from worldwide marketing experience with ZOSYN, occurring under circumstances where causal relationship to ZOSYN is uncertain:
Gastrointestinal—hepatitis, cholestatic jaundice
Hematologic—hemolytic anemia, anemia, thrombocytosis, agranulocytosis, pancytopenia
Immune––hypersensitivity reactions, anaphylactic/anaphylactoid reactions (including shock)
Infections––candidal superinfections
Renal—interstitial nephritis, renal failure
Skin and Appendages—erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis
Post-marketing experience with Zosyn in pediatric patients suggests a similar safety profile to that seen in adults.
Of the studies reported, including that of nosocomial lower respiratory tract infections in which a higher dose of ZOSYN was used in combination with an aminoglycoside, changes in laboratory parameters, without regard to drug relationship, include:
Hematologic —decreases in hemoglobin and hematocrit, thrombocytopenia, increases in platelet count, eosinophilia, leukopenia, neutropenia. The leukopenia/neutropenia associated with ZOSYN administration appears to be reversible and most frequently associated with prolonged administration, ie, ≥ 21 days of therapy. These patients were withdrawn from therapy; some had accompanying systemic symptoms (eg, fever, rigors, chills).
Coagulation —positive direct Coombs' test, prolonged prothrombin time, prolonged partial thromboplastin time
Hepatic —transient elevations of AST (SGOT), ALT (SGPT), alkaline phosphatase, bilirubin
Renal—increases in serum creatinine, blood urea nitrogen
Urinalysis —proteinuria, hematuria, pyuria
Additional laboratory events include abnormalities in electrolytes (ie, increases and decreases in sodium, potassium and calcium), hyperglycemia, decreases in total protein or albumin, blood glucose decreased, gamma-glutamyltransferase increased, hypokalemia, and bleeding time prolonged.
The following adverse reaction has also been reported for PIPRACIL® (piperacillin for injection):
Skeletal —prolonged muscle relaxation (See PRECAUTIONS, Drug Interactions.)
Piperacillin therapy has been associated with an increased incidence of fever and rash in cystic fibrosis patients.
There have been post-marketing reports of overdose with piperacillin/tazobactam. The majority of those events experienced, including nausea, vomiting, and diarrhea, have also been reported with the usual recommended dosages. Patients may experience neuromuscular excitability or convulsions if higher than recommended doses are given intravenously (particularly in the presence of renal failure).
Treatment should be supportive and symptomatic according to the patient's clinical presentation. Excessive serum concentrations of either piperacillin or tazobactam may be reduced by hemodialysis. Following a single 3.375 g dose of piperacillin/tazobactam, the percentage of piperacillin and tazobactam dose removed by hemodialysis was approximately 31% and 39%, respectively. (See CLINICAL PHARMACOLOGY.)
ZOSYN should be administered by intravenous infusion over 30 minutes.
The usual daily dose of ZOSYN for adults is 3.375 g every six hours totaling 13.5 g (12 g piperacillin/1.5 g tazobactam).
Initial presumptive treatment of patients with nosocomial pneumonia should start with ZOSYN at a dosage of 4.5 g every six hours plus an aminoglycoside, totaling 18.0 g (16.0 g piperacillin/2.0 g tazobactam). Treatment with the aminoglycoside should be continued in patients from whom Pseudomonas aeruginosa is isolated. If Pseudomonas aeruginosa is not isolated, the aminoglycoside may be discontinued at the discretion of the treating physician.
Due to the in vitro inactivation of the aminoglycoside by beta-lactam antibiotics, Zosyn and the aminoglycoside are recommended for separate administration. Zosyn and the aminoglycoside should be reconstituted, diluted, and administered separately when concomitant therapy with aminoglycosides is indicated. (See PRECAUTIONS, Drug Interactions.)
In circumstances where coadministration via Y-site is necessary, reformulated Zosyn containing EDTA supplied in Galaxy® containers is compatible for simultaneous coadministration via Y-site infusion only with the following aminoglycosides under the following conditions:
The following compatibility information does not apply to the Zosyn (piperacillin/tazobactam) formulation not containing EDTA. This information does not apply to Zosyn in vials or bulk pharmacy containers. Refer to the package insert for Zosyn vials or bulk pharmacy containers for instructions.
Zosyn Dose
Aminoglycoside Concentration Range*
*The concentration ranges in Table 5 are based on administration of the aminoglycoside in divided doses (10-15 mg/kg/day in two daily doses for amikacin and 3-5 mg/kg/day in three daily doses for gentamicin). Administration of amikacin or gentamicin in a single daily dose or in doses exceeding those stated above via Y-site with Zosyn containing EDTA has not been evaluated. See package insert for each aminoglycoside for complete Dosage and Administration instructions.
|2.25, 3.375, 4.5
|1.75– 7.5
|0.9% Sodium Chloride or 5% Dextrose
|2.25 or 4.5
|0.7 – 3.32
|0.9% Sodium Chloride
Zosyn Galaxy® containers are available as 2.25 g per 50 mL, 3.375 g per 50 mL, and 4.5 g per 100 mL. Zosyn 3.375 g per 50 mL Galaxy® containers are NOT compatible with gentamicin for coadministration via a Y-site due to the higher concentrations of piperacillin and tazobactam.
Zosyn is not compatible with tobramycin for simultaneous coadministration via Y-site infusion. Compatibility of Zosyn with other aminoglycosides has not been established. Only the concentration and diluents for amikacin or gentamicin with the dosages of Zosyn listed above have been established as compatible for coadministration via Y-site infusion. Simultaneous coadministration via Y-site infusion in any manner other than listed above may result in inactivation of the aminoglycoside by Zosyn.
In patients with renal insufficiency (Creatinine Clearance ≤ 40 mL/min), the intravenous dose of ZOSYN should be adjusted to the degree of actual renal function impairment. In patients with nosocomial pneumonia receiving concomitant aminoglycoside therapy, the aminoglycoside dosage should be adjusted according to the recommendations of the manufacturer. The recommended daily doses of ZOSYN for patients with renal insufficiency are as follows:
|Renal Function
(Creatinine Clearance, mL/min)
|All Indications (except nosocomial pneumonia)
|Nosocomial Pneumonia
* Creatinine clearance for patients not receiving hemodialysis
|>40 mL/min
|3.375 q 6 h
|4.5 q 6 h
|20-40 mL/min*
|2.25 q 6 h
|3.375 q 6 h
|<20 mL/min*
|2.25 q 8 h
|2.25 q 6 h
|2.25 q 12 h
|2.25 q 8 h
|2.25 q 12 h
|2.25 q 8 h
For patients on hemodialysis, the maximum dose is 2.25 g every twelve hours for all indications other than nosocomial pneumonia and 2.25 g every eight hours for nosocomial pneumonia. Since hemodialysis removes 30% to 40% of the administered dose, an additional dose of 0.75 g ZOSYN should be administered following each dialysis period on hemodialysis days. No additional dosage of ZOSYN is necessary for CAPD patients.
The usual duration of ZOSYN treatment is from seven to ten days. However, the recommended duration of ZOSYN treatment of nosocomial pneumonia is 7 to 14 days. In all conditions, the duration of therapy should be guided by the severity of the infection and the patient's clinical and bacteriological progress.
For children with appendicitis and/or peritonitis 9 months of age or older, weighing up to 40 kg, and with normal renal function, the recommended Zosyn dosage is 100 mg piperacillin/12.5 mg tazobactam per kilogram of body weight, every 8 hours. For pediatric patients between 2 months and 9 months of age, the recommended Zosyn dosage based on pharmacokinetic modeling, is 80 mg piperacillin/10 mg tazobactam per kilogram of body weight, every 8 hours (see PRECAUTIONS, General, Pediatric Use and CLINICAL PHARMACOLOGY). Pediatric patients weighing over 40 kg and with normal renal function should receive the adult dose. There are no dosage recommendations for Zosyn in pediatric patients with impaired renal function.
Zosyn in Galaxy containers should not be used in pediatric patients who require less than the full adult dose of Zosyn in order to prevent unintentional overdose. The other available formulations of Zosyn can be used in this population.
ZOSYN Injection (PL 2040 Plastic) is to be administered after thawing to room temperature using sterile equipment.
Administer by infusion over a period of at least 30 minutes. During the infusion it is desirable to discontinue the primary infusion solution.
ZOSYN should not be mixed with other drugs in a syringe or infusion bottle since compatibility has not been established.
ZOSYN is not chemically stable in solutions that contain only sodium bicarbonate and solutions that significantly alter the pH.
ZOSYN should not be added to blood products or albumin hydrolysates.
Store in a freezer capable of maintaining a temperature of -20°C (-4°F).
Thaw frozen container at room temperature 20°C to 25°C [68°F to 77°F] or under refrigeration (2°C to 8°C [36°F to 46°F]). DO NOT FORCE THAW BY IMMERSION IN WATER BATHS OR BY MICROWAVE IRRADIATION.
Check for minute leaks by squeezing container firmly. If leaks are detected, discard solution as sterility may be impaired.
The container should be visually inspected. Components of the solution may precipitate in the frozen state and will dissolve upon reaching room temperature with little or no agitation. Potency is not affected. Agitate after solution has reached room temperature. If after visual inspection the solution remains cloudy or if an insoluble precipitate is noted or if any seals or outlet ports are not intact, the container should be discarded.
The thawed solution is stable for 14 days under refrigeration (2°C to 8°C [36°F to 46°F]) or 24 hours at room temperature 20°C to 25°C [68°F to 77°F]. DO NOT REFREEZE THAWED ANTIBIOTICS.
CAUTION: Do not use plastic containers in series connections. Such use could result in air embolism due to residual air being drawn from the primary container before administration of the fluid from the secondary container is complete.
Preparation for administration:
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
ZOSYN® (piperacillin and tazobactam injection) in Galaxy® Container (PL 2040 Plastic) is supplied as a frozen, iso-osmotic, sterile, nonpyrogenic solution in single-dose plastic containers as follows:
2.25 g (piperacillin sodium equivalent to 2 g piperacillin/tazobactam sodium equivalent to 0.25 g tazobactam) in 50 mL. Each container has 5.58 mEq (128 mg) of sodium. Supplied 24/box—NDC 0206-8860-02
3.375 g (piperacillin sodium equivalent to 3 g piperacillin/tazobactam sodium equivalent to 0.375 g tazobactam) in 50 mL. Each container has 8.38 mEq (192 mg) of sodium. Supplied 24/box—NDC 0206-8861-02
4.5 g (piperacillin sodium equivalent to 4 g piperacillin/tazobactam sodium equivalent to 0.5 g tazobactam) in 100 mL. Each container has 11.17 mEq (256 mg) of sodium. Supplied 12/box—NDC 0206-8862-02
Store at or below -20°C (-4°F). [See DOSAGE AND ADMINISTRATION, DIRECTIONS FOR USE OF ZOSYN (PIPERACILLIN AND TAZOBACTAM INJECTION) IN GALAXY® CONTAINERS (PL 2040 PLASTIC).]
ZOSYN (piperacillin and tazobactam for injection) is also supplied as follows:
2.25 g single-dose vial containing piperacillin sodium equivalent to 2 g of piperacillin and tazobactam sodium equivalent to 0.25 g of tazobactam. Each vial contains 5.58 mEq (128 mg) of sodium. Supplied 10/box—NDC 0206-8852-16
3.375 g single-dose vial containing piperacillin sodium equivalent to 3 g of piperacillin and tazobactam sodium equivalent to 0.375 g of tazobactam. Each vial contains 8.38 mEq (192 mg) of sodium. Supplied 10/box—NDC 0206-8854-16
4.5 g single-dose vial containing piperacillin sodium equivalent to 4 g of piperacillin and tazobactam sodium equivalent to 0.5 g of tazobactam. Each vial contains 11.17 mEq (256 mg) of sodium. Supplied 10/box—NDC 0206-8855-16
ZOSYN (piperacillin and tazobactam for injection) is also supplied in the ADD-Vantage® Vial as follows:
2.25 g ADD-Vantage® vial (piperacillin sodium equivalent to 2 g piperacillin and tazobactam sodium equivalent to 0.25 g of tazobactam). Each ADD-Vantage® vial contains 5.58 mEq (128 mg) of sodium. Supplied 10/box—NDC 0206-8852-18
3.375 g ADD-Vantage® vial (piperacillin sodium equivalent to 3 g piperacillin and tazobactam sodium equivalent to 0.375 g of tazobactam). Each ADD-Vantage® vial contains 8.38 mEq (192 mg) of sodium. Supplied 10/box—NDC 0206-8854-18
4.5 g ADD-Vantage® vial (piperacillin sodium equivalent to 4 g piperacillin and tazobactam sodium equivalent to 0.5 g of tazobactam). Each ADD-Vantage® vial contains 11.17 mEq (256 mg) of sodium. Supplied 10/box—NDC 0206-8855-18
ZOSYN (piperacillin and tazobactam for injection) is also supplied as a powder in the pharmacy bulk vial as follows:
40.5 g pharmacy-bulk vial containing piperacillin sodium equivalent to 36 grams of piperacillin and tazobactam sodium equivalent to 4.5 grams of tazobactam. Each pharmacy-bulk vial contains 100.4 mEq (2,304 mg) of sodium. NDC 0206-8859-10
ZOSYN (piperacillin and tazobactam for injection) vials should be stored at controlled room temperature 20°C to 25°C (68°F to 77°F) prior to reconstitution.
CLINITEST® and DIASTIX® are registered trademarks of Ames Division, Miles Laboratories, Inc.
TES-TAPE® is a registered trademark of Eli Lilly and Company.
Galaxy® is a registered trademark of Baxter International, Inc.
ADD-Vantage® is a registered trademark of Abbott Laboratories.
United States Patent Numbers: 6,900,184 and 6,207,661
|This product's label may have been updated. For current package insert and further product information, please visit www.wyeth.com or call our medical communications department toll-free at 1-800-934-5556.
Manufactured for Wyeth Pharmaceuticals Inc.
by Baxter Healthcare Corporation, Deerfield, IL 60015
Wyeth Pharmaceuticals Inc.
Philadelphia, PA 19101
Rev 11/07
|Zosyn (Piperacillin sodium and Tazobactam sodium)
|Zosyn (Piperacillin sodium and Tazobactam sodium)
|Zosyn (Piperacillin sodium and Tazobactam sodium)
Data are from FDA and U.S. National Library of Medicine.


text:
Well-March is almost here and winter has not been too bad. I think we got off kind of easy-not a lot of snow, warmer days here and there and Spring is around the corner already! Plus, baseball season starts soon for my son-so I am pumped! Love watching him play...
I wanted to share a layout I created for my album using the new Tales of You and Me collection by Frankie! He designs the loveliest papers and this particular collection has been a huge hit in the scrappy world.
This collection has vintage imagery, with soft pinks and warm hues matched with cool plum tones-it's really beautiful. So, I decided to make a layout about Lili Wren when she was just a new babe in the world...
I love that there are some backgrounds with just a subtle pattern so that I can customize with art mediums, patterns from stencils and also add as many embellies as I wish without it being too busy.
As you can see-there are many ways to add additional color, texture and fun little surprises (stamped little hearts and bees) to make this project one-of-a-kind. And I am in love with the new boxed flowers from Prima, with the touch of rose gold on the petals.
This project will be a class at Auntie Em's in Cornwall, Ontario Canada this April. I am awaiting more details from the store before I can officially post-which I will do soon, along with the other classes I am teaching that weekend. So stay tuned!
Thanks for stopping by!


text:
On June 2, 2006, Axalto combined with Gemplus to form Gemalto, a leader in digital security.
The Gemplus website has been shut down and replaced by the Gemalto web site.
Here are some links you may find helpful:
Annual Report archive (includes Gemplus Annual reports)Gemplus Financial ResultsGemplus Press Release archive pageGemplus Shareholder meetings
If you are looking for Gemplus product support, try the
technical support site and/or the search engine (top right of this screen).
To contact the webmaster, please use the
contact form and specify "Web site problems" as the topic.


text:
2369 Banff Trail, N.W., Calgary, AB, Canada, T2M 4L2
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The Comfort Inn & Suites® University is conveniently set within walking distance of the University of Calgary and minutes from McMahon Stadium, Foothills Hospital, Canada Olympic Park, the Calgary Zoo and the Glenbow Museum. The city's LTR line is across the street from this Calgary hotel.
Calgary International Airport is about 15 minutes away and the Southern Alberta Institute of Technology, TELUS World of Science and Fort Calgary Historic Park are nearby.
All spacious, air-conditioned guest rooms feature voice mail, ironing equipment, safes, coffee makers and desks. Some feature refrigerators, microwaves and whirlpool bathtubs. Handicap accessible and non-smoking rooms are available.
Guests are invited to relax in the indoor heated pool and hot tub and kids will love the hotel's indoor water slide. Stay fit at the on-site exercise room. The meeting room accommodates up to 100 people for events and business functions.
Guests of this Comfort Inn hotel are invited to enjoy amenities including:
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