Intravenous and intramuscular.
Application in adults
In adults cefoperazone + sulbactam it is recommended to use in the following daily doses:
The daily dose should be divided into equal parts and administered every 12 hours.
In severe or refractory infections, the daily dose of cefoperazone + sulfate can be increased to 8 g (with a 1: 1 ratio of the major components, i.e. 4 g of cefoperazone and 4 g of sulbactam). If you need more than 8 g (with a 1: 1 ratio of the main components), an increase in the dose is achieved by the additional administration of cefoperazone. The dose should be divided into equal parts and administered every 12 hours.
The recommended maximum daily dose of sulbactam is 4 g.
Application for renal dysfunction
Patients with a creatinine clearance of 15-30 ml / min should receive a maximum of 1 g of sulbactam every 12 hours (maximum daily dose of sulbactam is 2 g), patients with creatinine clearance less than 15 ml / min - maximum 500 mg of sulbactam every 12 hours (maximum daily dose sulbactam - 1 g).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. In this regard, the administration of the drug should be carried out after dialysis.
In patients with impaired hepatic function and concomitant renal dysfunction, if regular monitoring of serum concentration of cefoperazone is not performed, the maximum daily dose should not exceed 2 g (see section "Special instructions").
Application the children
Children cefoperazone + sulbactam it is recommended to use in the following daily doses:
Dozu should be divided into equal parts and administered every 6-12 hours.
In severe or refractory infections, the daily dose of cefoperazone + sulbactam can be increased to 160 mg / kg / day (with a 1: 1 ratio of the major components, ie 80 mg / kg / day of cefoperazone and 80 mg / kg / day of sulbactam). If it is necessary to administer more than 160 mg / kg / day (with a 1: 1 ratio of the main components), an increase in dose is achieved by the additional administration of cefoperazone.The dose should be divided into equal parts and administered every 6-12 hours.
Application the newborns
In 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.
Method of preparing solutions for parenteral use
Preparation of the solution
| Total dose (g) | Equivalent doses | Scope | Max, the final |
| | cefoperazone + sulbactam (g) | solute | conc. (mg / ml) |
| | | bodies | |
| 1,0 | 0,5 + 0,5 | 3,4 | 125 + 125 |
Intramuscular injection
To prepare the solution for intramuscular injection, water for injection can be used (see table above).
For the convenience of administration, it is also possible to prepare a solution of the preparation with a concentration of cefoperazone 250 mg / ml or more. In this case, the solution is prepared in two steps, using water for injection as solvents first, and then 2% solution of lidocaine hydrochloride (see below), since for initial dissolution lidocaine hydrochloride solution can not be directly applied.
Preparation of a solution using lidocaine. Initially, the powder is dissolved in 1.3 ml of sterile water for injection, and then 0.4 ml of a 2% solution of lidocaine hydrochloride is added. The total volume of the solvent is 1.7 ml.The final solution will contain in 1 ml of a 0.5% solution of lidocaine hydrochloride about 250 mg of cefoperazone and about 250 mg of sulbactam.
Intravenous administration
To prepare a solution for infusion of 1 g (0.5 g + 0.5 g) of cefoperazone + sulbactam dissolved in the initial volume (approximately 3.4 ml) of one of the following infusion solutions: 5% glucose solution (dextrose), 5% glucose solution in physiological solution, 5% glucose solution in 0.225% sodium chloride solution, 0.9% sodium chloride solution or sterile water for injections, and then diluted to 20 ml with the same solution.
Preparation of the solution using Ringer's lactate. Since Ringer's lactate is not suitable for initial dilution, the solution is prepared in two steps: first use sterile water for injection (see table above), and then dilute the resulting solution with Ringer's lactate solution to a 5 mg / ml sulbactam concentration (2 ml of the initial solution diluted in 50 ml of Ringer's lactate solution or 4 ml in 100 ml of Ringer's lactate solution).
Infusion is carried out for 15-60 minutes.
For intravenous injection the contents of each vial should be dissolved in 3.4 ml of one of the solvents described in the preparation of the infusion solution (see above) and administered for a minimum of 3 minutes.