Sulperazon Dosage/Direction for Use

Adults: Daily dosage recommendation for Sulperazon in adults are as follows: See Table 3.


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Doses should be administered every 12 hrs in equally divided doses.
In severe or refractory infections, the daily dosage of Sulperazon may be increased up to 8 g of the 1:1 (ie, 4 g of cefoperazone activity). Patients receiving the 1:1 ratio may require additional cefoperazone administered separately. Doses should be administered every 12 hrs in equally divided doses.
The recommended maximum daily dosage of sulbactam is 4 g.
Children: Daily dosage recommendations for Sulperazon in children are as follows: See Table 4.


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Doses should be administered every 6-12 hrs in equally divided doses.
In serious or refractory infections, these dosages may be increased up to 160 mg/kg/day of the 1:1 ratio. Doses should be administered in 2-4 equally divided doses (see Use in children under Precautions and Toxicology under Actions).
Neonates: For neonates in the 1st week of life, Sulperazon should be given every 12 hrs. The maximum daily dosage of sulbactam in pediatrics should not exceed 80 mg/kg/day. For doses of Sulperazon requiring >80 mg/kg/day cefoperazone activity, additional cefoperazone should be administered separately (see Use in children under Precautions).
Elderly: See Pharmacokinetics under Actions.
Use in Hepatic Dysfunction: See Precautions.
Use in Renal Dysfunction: Dosage regimens of Sulperazon should be adjusted in patients with marked decrease in renal function (creatinine clearance of <30 mL/min) to compensate for the reduced clearance of sulbactam. Patients with creatinine clearances between 15 and 30 mL/min should receive a maximum of 1 g of sulbactam administered every 12 hrs (maximum daily dosage of 2 g sulbactam), while patients with creatinine clearances of <15 mL/min should receive a maximum of 500 mg of sulbactam every 12 hrs (maximum daily dosage of 1 g sulbactam). In severe infections, it may be necessary to administer additional cefoperazone. The pharmacokinetic profile of sulbactam is significantly altered by hemodialysis. The serum half-life of cefoperazone is reduced slightly during hemodialysis. Thus, dosing should be scheduled to follow a dialysis period.
Administration: IV: For intermittent infusion, each vial of Sulperazon should be reconstituted with the appropriate amount (see Instructions for Use/Handling: Reconstitution as follows) of 5% Dextrose in Water, 0.9% Sodium Chloride Injection or Sterile Water for Injection and then diluted to 20 mL with the same solution by administration over 15-60 min.
Lactated Ringer's Solution is a suitable vehicle for IV infusion, however, not for initial reconstitution (see Incompatibilities: Lactated Ringer's Solution under Interactions, and Instructions for Use/Handling: Lactated Ringer's Solution as follows).
For IV injection, each vial should be reconstituted as mentioned previously administered over a minimum of 3 min.
IM: Lidocaine HCl 2% is a suitable vehicle for IM administration, however, not for initial reconstitutions (see Incompatibilities: Lidocaine under Interactions, and Instructions for Use/Handling: Lidocaine as follows).
Instructions for Use/Handling: Reconstitution: See Table 5.


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Sulperazon has been shown to be compatible with water for injection, 5% dextrose, normal saline, 5% dextrose in 0.225% saline and 5% dextrose in normal saline at concentrations of 10 mg cefoperazone and 5 mg sulbactam per mL and up to 250 mg cefoperazone and 125 mg sulbactam per mL.
Lactated Ringer's Solution: Sterile Water for Injection should be used for reconstitution (see Incompatibilities: Lactated Ringer's Solution under Interactions). A 2-step dilution is required using Sterile Water for Injection (shown in Table 5) further diluted with Lactated Ringer's Solution to a sulbactam concentration of 5 mg/mL (use 2 mL initial dilution in 50 mL or 4 mL initial dilution in 100 mL Lactated Ringer's Solution).
Lidocaine: Sterile Water for Injection should be used for reconstitution (see Incompatibilities: Lidocaine under Interactions). For a concentration of cefoperazone of ≥250 mg/mL, a 2-step dilution is required using Sterile Water for Injection (shown in Table 5) further diluted with 2% lidocaine to yield solutions containing up to 250 mg cefoperazone and 125 mg sulbactam per mL in approximately 0.5% lidocaine HCl solution.