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The piperacillin component of piperacillin plus tazobactam interacts with methotrexate and can result in increased methotrexate serum levels due to the competition of penicillin with methotrexate for excretion sites in renal tubules

Acknowledgements This work was partially supported by grants from JSPS (KAKENHI Grant Numbers JP21K08032 and 24K11270) to KS

The Istanbul Vision 2050 Strategic Document and Vision 2050 Action Plan emphasise the need for a new planning paradigm in response to ongoing local and global transformations