Salbec Dosage/Direction for Use

Administration in adults: Daily dosage recommendations for sulbactam/cefoperazone in adults are as follows: See Table 4.

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Daily dose should be administered every 12 hours in equally divided doses.
In severe or refractory to the treatment infections, the daily dose of sulbactam/cefoperazone may be increased up to 8 g from the 1:1 ratio (i.e., cefoperazone activity - 4 g).
Patients receiving the 1:1 ratio may require additional cefoperazone, administered separately. Daily dose should be administered every 12 hours in equally divided doses. The recommended maximum daily dosage of sulbactam is 4 g.
Administration in hepatic impairment: See Precautions.
Administration in renal impairment: In patients with significantly impaired renal function (creatinine clearance < 30 ml/min), dosage regimen should be corrected in order to compensate the reduced sulbactam clearance. In patients with creatinine clearance between 15 and 30 ml/min, 1 g sulbactam should be administered, every 12 hours at the most (maximum daily dose sulbactam- 2 g), while in patients with creatinine clearance under 15 ml/min, 500 mg sulbactam should be administered, every 12 hours at the most (maximum daily dose sulbactam- 1 g). Additional administration of cefoperazone may be required in severe infections.
The pharmacokinetic profile of sulbactam is significantly altered by haemodialysis. The serum half-life of cefoperazone is reduced slightly during haemodialysis. Thus, dosing should be scheduled to follow a dialysis period.
Administration in elderly: See Pharmacology: Pharmacokinetics under Actions.
Administration in children: Daily dosage recommendations for sulbactam/cefoperazone in children are as follows: See Table 5.

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Daily dose should be administered every 6 to 12 hours, in equally divided doses.
In serious or refractory to the treatment infections, these doses may be increased up to 160 mg/kg/day from the ratio 1:1 (i.e., cefoperazone activity - 160 mg/kg/day). Daily dose should be administered in two to four equally divided doses (see Use in Children under Precautions and Pharmacology: Pharmacokinetics: Administration in children under Actions).
Administration 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 children should not exceed 80 mg/kg/day (see Use in Children under Precautions).
Intravenous Administration: For intermittent intravenous infusion, each vial of sulbactam/cefoperazone should be reconstituted with the appropriate amount (see Instructions for Use/Handling 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 Instructions for Use/Handling: Lactated Ringer's Solution under Cautions for Usage).
For intravenous injection, each vial should be reconstituted as previously described and to be 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 Instructions for Use/Handling: Lidocaine under Cautions for Usage).