The drug is administered parenterally: intramuscularly or intravenously.
Adults and children over 12 years of age: the usual dose is 1-2 g of ceftriaxone (0.5-1 g of sulbactam) once a day or divided into two injections (every 12 hours).
In severe cases or infections, the causative agents of which have only moderate sensitivity to ceftriaxone, the daily dose can be increased to 4 g.
The maximum daily dose of sulbactam is 4 g. The duration of treatment depends on the course of the disease. As always with antibiotic therapy, the administration of Broadsef-S should be continued for at least 48-72 hours after the temperature is normalized and the eradication of the pathogen is confirmed. The course of treatment is usually 4-14 days; with complicated infections, a longer duration of administration may be required. The course of treatment for infections caused by Streptococcus pyogenes, must be at least 10 days.
In patients with impaired renal function There is no need to reduce the dose if the liver function remains normal.In chronic renal failure (CC less than 15 ml / min) - the daily dose should not exceed 2 g of ceftriaxone and 1 g of sulbactam.
In patients with hepatic dysfunction there is no need to reduce the dose if the kidney function remains normal.
When combination of renal and hepatic insufficiency should regularly determine the concentration of ceftriaxone in the plasma and, if necessary, adjust its dose. The daily dose should not exceed 2 g without determining the concentration of ceftriaxone in the blood plasma.
Patients on hemodialysis do not require an additional dose after a hemodialysis session, however, it is necessary to control the concentration of ceftriaxone in the plasma, since its excretion in such patients can be slowed down (dose adjustment may be required).
Elderly patients: usual doses for adults, without adjustments for age.
Children under 12 years old
When using the drug once a day, it is recommended to adhere to the following dosing regimens:
Newborns (up to 2 weeks): 20-50 mg / kg body weight ceftriaxone (10-25 mg / kg sulbactam) once a day. The daily dose of ceftriaxone should not exceed 50 mg / kg of body weight.
Newborns, infants and young children (from 15 days to 12 years): the recommended daily dose of ceftriaxone is 20-80 mg / kg (10-40 mg / kg sulbactam) once a day or divided into 2 divided doses (every 12 hours). The total daily dose of ceftriaxone in children should not exceed 2 g; the maximum daily dose of sulbactam should not exceed 80 mg / kg. A dose of 50 mg / kg body weight and more (ceftriaxone) should be given as an IV infusion within 30 minutes. When treatment of acute otitis media in children is recommended a single I / m injection at a dose of 50 mg / kg (but not more than 1 g).
In children with a body weight of 50 kg or more, doses for adults are used.
Bacterial meningitis
For bacterial meningitis in infants and young children, treatment starts with a dose of 100 mg / kg ceftriaxone (but not more than 4 g) once a day (50 mg / kg sulbactam, but not more than 2 g). After identifying the pathogen and determining its sensitivity, the dose can be reduced accordingly. The best results with meningococcal meningitis were achieved with a treatment duration of 4 days, with meningitis caused by Haemophilus influenzae - b days, Streptococcus pneumoniae - 7 days.
Lyme disease (borreliosis): adults and children - 50 mg / kg (the highest daily dose - 2 g) ceftriaxone once a day for 14 days.
Uncomplicated gonorrhea - a single intravenous injection of 250 mg (ceftriaxone).
Prevention of postoperative infections, depending on the degree of infectious risk, 1-2 g of ceftriaxone (0.5-1 g of sulbactam) is administered once for 30-90 min before the start of the operation. In operations on the colon and rectum, simultaneous (but separate) administration of ceftriaxone / sulbactam and one of the drugs from the 5-nitroimidazoles group was well established.
Rules for the preparation and administration of solutions: Use only freshly prepared solutions.
For intramuscular injection: the contents of the vial (1.5 g) are dissolved in 3.5 ml of water for injection or 1% solution of lidocaine. After preparation, each ml of the solution contains about 250 mg in terms of ceftriaxone.
If necessary, a more dilute solution may be used. As with other intramuscular injections, the drug is injected into a relatively large muscle; Trial aspiration helps to avoid unintentional insertion into the blood vessel. It is recommended to inject no more than 1000 mg of ceftriaxone (500 mg of sulbactam) into one relatively large muscle. Do not inject a solution containing lidocaine, intravenously.
For intravenous administration: the contents of the vial are dissolved in 10 ml of water for injection. After preparation, each ml of the solution contains about 100 mg in terms of ceftriaxone. The solution is administered slowly for 2-4 minutes.
For intravenous infusion dissolve 2 g of ceftriaxone (1 g of sulbactam) in 40 ml of one of the following solutions that do not contain calcium (0.9% sodium chloride solution, 5% or 10% dextrose solution, 6% dextrin solution in 5% dextrose solution). The solution is introduced for 30 minutes.