Severe renal impairment and liver, children up to 3 months. In pregnancy, the drug is used only if the expected benefit to the mother outweighs the potential risk to the fetus. If test phenylpropionate necessary, the appointment during lactation should stop breastfeeding.
Dosage and administration
intravenously and intramuscularly.
The daily dose should be divided into equal portions and injected every 12 hours. In severe or refractory infections the daily dose of cefoperazone / sulbactam can be increased to 8 g at a ratio of the main components of 1: 1 (ie, 4 g cefoperazone).
Patients treated with cefoperazone / sulbactam in a 1: 1 ratio may require additional cefoperazone administration. The dose should be divided into equal portions and injected every 12 hours.
The recommended maximum daily dose of sulbactam is 4 g
Application for violations of renal function
Patients with creatinine clearance 15-30 ml / min, the maximum dose test phenylpropionate of 1 g of sulbactam every 12 hours (maximum daily dosage of 2 g sulbactam), while patients with creatinine clearance less than 15 ml / min, the maximum dose of sulbactam is 500 mg every 12 hours (maximum daily dosage of sulbactam 1 g). In severe infections may require additional cefoperazone administration.
The pharmacokinetics of sulbactam is significantly changed by dialysis. Poluvyvedeiiya period of cefoperazone serum decreases slightly during hemodialysis. Therefore, the introduction of the drug should be planned after dialysis.
Application for violations of liver function
If the regular monitoring of serum concentrations of cefoperazone is not carried out, the maximum daily dose should not exceed 2 g (see. “Special Instructions” section).
he dose should be divided into equal parts and be given every 6-12 hours.
In severe or refractory infections, these dosages can be increased to 160 mg / kg / d ratio of the basic components of 1: 1. The daily dose is divided into 2-4 equal portions.
Use in infants
In neonates during the first week of life, the drug should be administered every 12 hours. The maximum daily dose of sulbactam in children should not exceed 80 mg / kg / day.
Preparing a solution by using lidocaine. To prepare test phenylpropionate the solution for intramuscular injection may be used 2% lidocaine hydrochloride solution, but it can not be used for the initial dissolution because of their incompatibility. Compatibility can be achieved by two-step preparation of the solution – the powder initially dissolved in sterile water for injection and then diluted with 2% lidocaine hydrochloride. The total volume of the solvent is 6.7 ml. The final solution will contain cefoperazone / sulbactam in a ratio of 125 mg / 125 mg in 1 ml of 0.5% lidocaine solution.
For preparation of a solution for intravenous infusion is diluted 2 g (1 g + 1 g) and sulbactam cefoperazone in the initial volume of 6.7 ml of infusion solutions of the following: 5% dextrose in water, 5% dextrose in 0.225% sodium chloride, 5% dextrose in saline, 0.9% sodium chloride solution or sterile water for injection and then diluted to 20 ml with the same solvent. Preparation of the solution using a Ringer’s lactate. since lactate is not suitable for the initial dilution solution was prepared in two steps: first using water for injection (see table.), and then the resulting solution was diluted with a solution of test phenylpropionate lactate at a concentration of sulbactam 5 mg / ml (2 ml of the initial solution is diluted in 50 ml s lactate or 4 ml in 100 ml Ringer’s lactate solution) . infusion is carried out for 15-60 min.