In / m and / in (slowly streaming or drip). The drug is injected deep in the / m into the large gluteus muscle or the anterior surface of the thigh. For intravenous administration of slow jet injection, the maximum single dose is 2 g; duration of administration - at least 3-5 minutes. The duration of IV infusion is 15-60 minutes. Doses and duration of treatment are determined by the nature and severity of the infection and are set individually.
The dose for adults is -2-4 g / day, divided into 2 injections (every 12 hours).In severe infections, the dose can be increased to 8 g / day, divided into 2 injections (every 12 hours). Treatment with the drug can begin before the results of a study of the sensitivity of microorganisms.
With uncomplicated gonococcal urethritis - once in / m in a dose of 500 mg. Prevention of postoperative complications: 1 g or 2 g IV for 30-90 min before the start of operations, followed by repeated administration every 12 hours (in most cases for no more than 24 hours). In operations with an increased risk of infection (for example, operations in the colorectal area), in open-heart surgery or joint replacement, prophylactic use can continue for 72 hours after the operation is completed.
Dose correction may be required in cases of severe bile duct obstruction, severe liver disease, or concomitant liver and kidney dysfunction. In this case, the daily dose should not exceed 2 g.
Because the
cefoperazone is mainly excreted with bile, then dose adjustments for
violation of kidney function when used in recommended doses (2-4 g / day) is not required. At a glomerular filtration rate of less than 18 ml / min or a serum creatinine concentration greater than 3.5 mg / dl, the daily dose should not exceed 4 g.When hemodialysis, the drug should be administered after the end of the dialysis session. It is recommended to monitor the concentration of cefoperazone in the blood serum (provided that the daily dose exceeds 2 g) with a combined violation of liver function and kidney, and if necessary adjust the dose.The dose for children is 50-200 mg / kg / day, divided into equal parts, administered every 8-12 hours. The maximum dose is 12 g / day. With IV slow injection, the maximum single dose is 50 mg / kg; duration of administration - not less than 3-5 min. Newborns - (aged less than 8 days) - 50-200 mg / kg / day in equal parts every 12 hours.
In the treatment of infections caused by Streptococcus pyogenes, in adults and children, the duration of therapy should be at least 10 days.
Preparation of solutions:
Intramuscular injection:
To prepare solutions, sterile water for injection is used. If it is necessary to prepare a solution with a concentration of 250 mg / ml or more, a lidocaine solution is recommended as a solvent, which is prepared by diluting a 2% solution of lidocaine in sterile water for injection (approximate concentration of lidocaine hydrochloride in the resulting solution is 0.5%).It is recommended to dilute the drug in two stages:
1) the necessary amount of sterile water for injection is first added and shaken until the powder is completely dissolved;
- then add the necessary amount of 2% lidocaine solution and mix.
The ultimate | Stage 1 | 2 stage |
|
concentration | The volume is sterile | Volume of 2% solution | Entered volume * |
cefoperazone | water for injection | lidocaine | |
250 mg / ml | 2.6 ml | 0,9 ml | 4.0 ml |
333 mg / ml | 1.8 ml | 0.6 ml | 3,0 ml |
[1] - Excess volume allows to completely fill the syringe of the specified volume.
IV introduction.
The contents of the vial are first dissolved in one of the following compatible solutions for intravenous administration (at a rate of at least 2.8 ml per 1 g of cefoperazone): 5% dextrose injection, 10% solution of dextrose for injection, 5% dextrose solution in 0.9% solution of sodium chloride for injection, 0.9% solution of sodium chloride for injection, 5% dextrose solution in 0.2% solution of sodium chloride for injection, sterile water for injections. To facilitate dissolution, it is recommended to use 5 ml of solvent per 1 g of cefoperazone.
Then the resulting solution is further diluted in one of the above solvents.
Intravenous drip introduction
The contents of the vial are dissolved in 20 to 100 ml of a compatible intravenous solution of the above. When used as a solvent for sterile water for injection, its volume should not exceed 20 ml. Infusion is carried out for 15 minutes up to 1 hour;
Intravenous jet slow introduction
The maximum dose of cefoperazone should not exceed 2 g per administration in adults and 50 mg / kg of body weight in children. The drug is dissolved in a suitable solvent (final concentration of 100 mg / ml) and injected for 3-5 minutes.