Intramuscularly and intravenously (slowly struino or drip).
The drug is injected deep inside the large gluteus muscle or the anterior surface of the thigh.
With intravenous slow jet injection, the maximum single dose is 2 g; duration of administration - at least 3-5 minutes. Duration of intravenous injectionpelvic administration - 15-60 minutes. 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. In uncomplicated gonococcal urethritis - once intramuscularly at a dose of 500 mg. Prevention of postoperative complications: 1 g or 2 g intravenously for 30-90 minutes before the operation, followed by repeated administration every 12 hours (in most cases within 24 hours).
In operations with an increased risk of infection (eg, operations in the colorectal area), in open-heart surgery or joint replacement, preventive use may continue for up to 72 hours after the completion of the operation.
Dose correction may be required in cases of severe obstruction of the biliary tract, severe liver disease, or with concurrent liver and kidney dysfunction. In this case, the daily dose should not exceed 2 g. Since cefoperazone basically it is deduced with bile, then correction of the dose in 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 half-life of cefoperazone from the blood serum decreases slightly, so 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 (assuming that the daily dose is more than 2 g) with a combined disturbance of liver and kidney function 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 intravenous slow jet injection. the maximum single dose is 50 mg / kg; duration of administration - at least 3-5 minutes. 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 for intravenous and intramuscular administration.
Intravenous administration
Intravenous intravenous injection. The contents of the vial (1 g of cefoperazone) are dissolved first in 2.8 ml of the solvent for intravenous administration. To facilitate dissolution, 5 ml of solvent per g of cefoperazone is recommended. For the initial dilution the following solutions are used:-5% dextrose injection, 10% dextrose injection, 0.9% sodium chloride solution for injection, 5% dextrose solution and 0.9% sodium chloride solution for injection, 5% dextrose solution and 0.2% sodium solution chloride for injection, sterile water for injections.
After adding the solvent, the contents of the vial are shaken well until completely dissolved.
Then the whole solution should be diluted in 5-10 ml of one of the following solvents for intravenous administration: 5% dextrose injection, 10% dextrose injection, 5% dextrose solution and Ringer's lactated solution for injection, Ringer's lactated solution, 5 % dextrose solution and 0.9% sodium chloride solution for injection, 0.9% sodium chloride solution for injection.
Drip intravenous. The contents of the vial (1 g of cefoperazone) are dissolved in 20-100 ml of the solvent for intravenous administration. If the solvent is used water for injections, then no more than 20 ml is added to the vial with the drug.
Intramuscular injection. For the preparation of solutions intended for intramuscular injection, sterile water for injections. In the cases, when it is intended to administer the drug at a concentration in excess of 250 mg / ml, a 2% solution of lidocaine is recommended for solution preparation. The following two-step dilution method is recommended: to achieve a concentration of cefoperazone 250 mg / ml in a vial containing 1 g of cefoperazone, add 2.6 ml of water for injection, agitate until complete dissolution of the preparation, and then add 0.9 ml of a 2% solution of lidocaine.The final volume will be 4 ml. To achieve a cefoperazone concentration of 333 mg / ml, 1.8 ml of water for injection is added to a vial containing 1 g of cefoperazone, agitated until the drug is completely dissolved, and then 0.6 ml of a 2% solution of lidocaine is added. The final volume will be 3 ml.