Adverse effects
Common side effects associated with the administration of piperacillin-tazobactam include:
Gastrointestinal: constipation, diarrhea, nausea, vomiting
Dermatologic: erythema, pain, phlebitis, rash
Neurologic: headaches, insomniaProlonged periods of piperacillin-tazobactam therapy have been associated with the potential development of hematologic adversities such as leukopenia (16.3%), neutropenia (10%), and eosinophilia (10%) in adult patients. The combination of piperacillin-tazobactam with other antibiotics was found to be a major risk factor for leukopenia as well. Additionally, the chances of developing these illnesses increases in younger patients with fewer conditions, prolonging their time to recover.Other cases of adverse effects include instances of renal dysfunction, hepatitis, hyperactivity, anemia, abnormalities in coagulation, and hypokalemia. Allergic reactions can be induced from the side chains of β-lactam antibiotics such as amoxicillin, or antibodies surrounding the nucleus of penicillin. Interactions
The combination of piperacillin and tazobactam, commonly branded as Zosyn, improves their overall bactericidal activity as amino-benzylpenicillins and ureidopencillins work synergistically with β-lactamase inhibitors. Concurrent use or unregulated dosages of piperacillin results in increasing levels of piperacillin within the body, prolonging neuromuscular transmission blockages created by non-depolarizing muscle relaxants, and disruptions in urine tests for glucose. Some compounds that may interfere with the bactericidal activity of piperacillin include chloramphenicol, macrolides, and sulfonamides. Following two studies conducted in 1986 and 2006, piperacillin was found to inhibit the removal of methotrexate in animal kidneys. Furthermore, in the presence of piperacillin-tazobactam, the decay time for methotrexate triples in comparison to the normal half-life, leaving the patient exposed to cytotoxic effects produced by the chemical agent.
Similarly, fungus can be seen under a microscope or found on a culture. Some viral infections may cause a rash with boils on a reddish base. Rashes caused by herpes simplex virus and varicella zoster virus in particular may be confused with erythema toxicum neonatorum. These viruses are diagnosed by scraping the base of a lesion. Multinucleated giant cells can be seen under a microscope. Some of these tests may be ordered if the diagnosis is unclear. Treatment
Erythema toxicum neonatorum resolves without treatment, typically within one or two weeks. There are no associated systemic symptoms or long-term consequences of the rash. History
The rash of erythema toxicum neonatorum has been described by doctors for centuries. Ancient Mesopotamians believed that it represented a cleansing mechanism against the mothers blood. Later physicians believed that it was caused by the skins response to meconium. The name erythema toxicum neonatorum was first used by Dr. Karl Leiner in 1912 because he believed that the rash was caused by enterotoxins. Although Leiners hypothesis was incorrect and the rash is not actually caused by toxins, the medical community continues to call the rash erythema toxicum neonatorum. References


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