Intravenously (intravenously) (struino and drip) and intramuscularly (IM). With a single dose exceeding 2 g of the drug, preferably iv administration.
Application in adults. In adults, cefoperazone + sulbactam it is recommended to use in the following daily doses:
| Ratio | Daily dose, grams |
| Cefoperazone + sulbactam | Sulbactam | Cefoperazone |
| 1:1 | 2,0-4,0 | 1.0-2.0 | 1,0-2,0 |
The daily dose should be divided into equal parts and administered every 12 hours.
In severe or refractory infections, the daily dose of the drug cefoperazone + sulbactam can be increased to 8 g at a ratio of the main components of 1: 1 (eg 4 g of cefoperazone). Patients receiving cefoperazone + sulbactam in a ratio of 1: 1, additional administration of cefoperazone may be required. The daily dose of the drug should be divided into equal parts and administered every 12 hours. The recommended maximum daily dose of sulbactam is 4 g.
Application in renal failure. In patients with creatinine clearance less than 30 mL / min, the dose of the drug cefoperazone + sulbactam is calculated by the dose of sulbactam, as shown in the table below:
| Creatinine clearance | The maximum dose of sulbactam |
| 15-30 ml / min | 1 g every 12 h |
| less than 15 ml / min | 500 mg every 12 hours |
In severe infections, additional administration of cefoperazone may be required. The pharmacokinetics of sulbactam significantly changes during hemodialysis. The half-life of cefoperazone from the blood serum decreases slightly during hemodialysis.Therefore, the administration of the drug should be planned after dialysis.
When a violation of liver function Dose changes may be required in cases of severe biliary obstruction, severe liver disease, and renal failure, combined with any of these conditions. In patients with hepatic insufficiency and concomitant renal insufficiency, it is necessary to monitor the concentration of cefoperazone in the serum and dose adjustment if necessary. If the daily dose of cefoperazone does not exceed 2 g, there is no need to monitor its serum concentration.
Use in children. Children cefoperazone + sulbactam it is recommended to use in the following doses:
| Ratio | Daily dose, mg / kg / day |
| Cefoperazone + sulbactam | Sulbactam | Cefoperazone |
| 1:1 | 40-80 | 20-40 | 20-40 |
The dose should be divided into equal parts and administered every 6-12 hours.
In severe or refractory infections, the daily dose of the drug can be increased to 160 mg / kg / day (with the ratio of the main components 1: 1), which is divided into 2-4 equal parts.
Newborns During the first week of life, the drug should be injected every 12 hours.The maximum daily dose of sulbactam in children should not exceed 80 mg / kg / day.
Preparation of solutions for the duration of parenteral administration
Breeding:
| Dose preparation, g | Equivalent doses Cefoperazone + sulbactam, g | Volume of solvent, ml | Maximum final concentration, mg / ml |
| 1,0 | 0,5+0,5 | 3,4 | 125+125 |
| 2,0 | 1,0+1,0 | 6.8 | 125+125 |
| 3,0 | 1,5+1,5 | 10,2 | 125+125 |
| 4,0 | 2,0+2,0 | 13,6 | 125+125 |
Intramuscular injection. To prepare the solution for the / m administration, use water for injection (see table) or 2% lidocaine solution. 2% lidocaine solution can not be used for the initial dilution of cefoperazone + sulbactam. given their pharmaceutical incompatibility. Compatibility can be achieved by 2-step solution preparation. For primary dilution, use water for injection in the volumes indicated below:
1,0 g (0.5 g + 0.5 g) of cefoperazone + sulbactam - 2.6 ml;
2,0 g (1.0 g + 1.0 g) of cefoperazone + sulbactam 5.0 ml.
Then the resulting solution is diluted with a 2% solution of lidocaine, adding 0.8 ml or 1.7 ml of local anesthetic to the dilution obtained at the initial dilution containing 1.0 g or 2.0 g of cefoperazone + sulbactam, respectively, in order to obtain an antibiotic solution in 0.5% solution of lidocaine.
Enter deeply intramuscularly in areas of the body with a pronounced muscular layer, for example, the upper-outer quadrant of the buttock).
Intravenous administration.
For IV injection the contents of the vial are dissolved as indicated in the table with one of the following infusion solutions: 5% dextrose solution, 0.9% sodium chloride solution, 5% dextrose solution in 0.225% sodium chloride solution, 5% dextrose solution in 0.9% sodium solution chloride or water for injections. The resulting solution is administered for a minimum of 3 minutes.
For IV infusion, the contents of the vial are dissolved as indicated in the table with one of the following infusion solutions: 5% dextrose solution, 0.9% sodium chloride solution, 5% dextrose solution in 0.225% sodium chloride solution, 5% dextrose solution in 0 , 9% solution of sodium chloride or water for injections; the resulting solution is diluted to 20-100 ml with the same solvent used for the initial dissolution. Enter in / in the drip for 15-60 minutes.
Drug solutions for intravenous and intramuscular administration prepared using these solvents can be stored for 24 hours at room temperature (25 ° C) or for 48 hours in a refrigerator (2 to 8 ° C).
Preparation of the solution using Ringer's lactate. Since Ringer's lactate solution is not suitable for initial dilution, the solution is prepared in two steps: first, use water for injection (cf.(see table above), and then the resulting solution is diluted with Ringer's lactate solution to a concentration of 5 mg / ml of sulbactam (each 1 ml of the initial solution is diluted with 25 ml Ringer's lactate solution).