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| Dosages: | Use in Adults:
Daily dosage recommendations for sulbactam/cefoperazone in adults are as follows:
Sulbactam Cefoperazone
Ratio SBT/CPZ (g) Activity(g) Activity(g)
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1:1 2.0 - 4.0 1.0 - 2.0 1.0 - 2.0
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Doses should be administered every 12 hours in equally divided doses.
In severe or refractory infections the daily dosage of sulbactam/cefoperazone may be increased up to 8 g of the 1:1 ratio (i.e., 4 g cefoperazone activity). Patients receiving the 1:1 ratio may require additional cefoperazone administered separately. Doses should be administered every 12 hours in equally divided doses.
The recommended maximum daily dosage of sulbactam is 4 g.
Use in Hepatic Dysfunction:
See section 4.4 Special Warnings and Special Precautions for Use.
Use in Renal Dysfunction
Dosage regimens of sulbactam/cefoperazone should be adjusted in patients with marked decrease in renal function (creatinine clearance of less than 30 ml/min) to compensate for the reduced clearance of sulbactam. Patients with creatinine clearances between 15 and 30 ml/min should receive a maximum of 1 g of sulbactam administered every 12 hours (maximum daily dosage of 2 g sulbactam), while patients with creatinine clearances of less than 15 ml/min should receive a maximum of 500 mg of sulbactam every 12 hours (maximum daily dosage of 1 g sulbactam). In severe infections it may be necessary to administer additional cefoperazone.
The pharmacokinetic profile of sulbactam is significantly altered by hemodialysis. The serum half life of cefoperazone is reduced slightly during hemodialysis. Thus, dosing should be scheduled to follow a dialysis period.
Use in Elderly
See section 5.2 Pharmacokinetic Properties.
Use in Children
Daily dosage recommendations for sulbactam/cefoperazone in children are as follows:
Sulbactam Cefoperazone
Ratio SBT/CPZ (g) Activity(g) Activity(g)
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1:1 40 - 80 20 - 40 20 - 40
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Doses should be administered every 6 to 12 hours in equally divided doses.
In serious or refractory infections, these dosages may be increased up to 160 mg/kg/day. Doses should be administered in two to four equally divided doses (see section 4.4 Special Warnings and Special Precautions for Use Use in Infancy and section 5.3 Preclinical Safety Data Use in Pediatrics).
Use in Neonates
For neonates in the first week of life, the drug should be given every 12 hours. The maximum daily dosage of sulbactam in pediatrics should not exceed 80 mg/kg/day. If more than 80 mg/kg/day of cefoperazone activity are necessary, additional cefoperazone should be administered separately (see section 4.4 Special Warnings and Special Precautions for Use Use in Infancy).
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