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Click on icon to see table/diagram/imageDoses should be administered every 12 hours in equally divided doses.
8 g of the 1:1 ratio (i.e., 4 g cefoperazone activity). Patients receiving the 1:1 ratio may require additional cefoperazone administered separately. Doses should be administered every 12 hours in equally divided doses.
The recommended maximum daily dosage of sulbactam is 4 g.
Use in Hepatic Dysfunction: See Precautions.
Use in Renal Dysfunction: Dosage regimens of sulbactam/cefoperazone should be adjusted in patients with marked decrease in renal function (creatinine clearance of less than 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 hours (maximum daily dosage of 2 g sulbactam), while patients with creatinine clearances of less than 15 ml/min should receive a maximum of 500 mg of sulbactam every 12 hours (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 haemodialysis. The serum half-life of cefoperazone is reduced slightly during hemodialysis. Thus, dosing should be scheduled to follow a dialysis period.
Use in Elderly: See Pharmacology: Pharmacokinetics under Actions.
Use in Children: Daily dosage recommendations for sulbactam/cefoperazone in children are as follows: (See Table 4.)
Click on icon to see table/diagram/imageDoses should be administered every 6 to 12 hours 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 two to four equally divided doses (see Use in Infancy under Precautions and Pharmacology: Toxicology: Preclinical Safety Data - Use in Pediatrics under Actions).
Use in Neonates: For neonates in the first week of life, the drug should be given every 12 hours. The maximum daily dosage of sulbactam in pediatrics should not exceed 80 mg/kg/day. For doses of sulbactam/cefoperazone requiring more than 80 mg/kg/day cefoperazone activity, additional cefoperazone should be administered (see Use in Infancy under Precautions).
Intravenous Administration: For intermittent infusion, each vial of sulbactam/cefoperazone should be reconstituted with the appropriate amount (see Special Precautions for Disposal and Other Handling - Reconstitution under Cautions for Usage) 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 followed by administration over 15 to 60 minutes.
Lactated Ringer's Solution is a suitable vehicle for intravenous infusion, however, not for initial reconstitution (see Incompatibilities - Lactated Ringer's Solution and Special Precautions for Disposal and Other Handling - Lactated Ringer's Solution under Cautions for Usage).
For intravenous injection, each vial should be reconstituted as previously mentioned and administered over a minimum of 3 minutes.
Intramuscular Administration: Lidocaine HCl 2% is a suitable vehicle for intramuscular administration, however, not for initial reconstitution (see Incompatibilities - Lidocaine and Special Precautions for Disposal and Other Handling - Lidocaine under Cautions for Usage).
