Cefoperazone-Sulbactam

Cefoperazone, a third-generation cephalosporin, inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to bactericidal action. Sulbactam is a beta-lactamase inhibitor that irreversibly inactivates a broad spectrum of bacterial beta-lactamases, thereby protecting cefoperazone from degradation and extending its antimicrobial spectrum, especially against resistant strains.

Adult

2-4 g (cefoperazone component) IV/IM daily, given in equally divided doses every 12 hours. For severe infections, the dose may be increased up to 8 g/day (cefoperazone component) in 2-4 divided doses.

Pediatric

40-80 mg/kg/day (cefoperazone component) IV/IM, given in 2-4 equally divided doses. For severe infections, up to 160 mg/kg/day (cefoperazone component) may be administered in 2-4 divided doses, not exceeding 8 g/day cefoperazone.

Renal adjustment

CrCl > 30 mL/min: No adjustment. CrCl 15-30 mL/min: Usual dose every 12 hours, but limit sulbactam to 1 g every 12 hours. CrCl < 15 mL/min: Usual dose every 12 hours, but limit sulbactam to 500 mg every 12 hours. Administer after hemodialysis.

Hepatic adjustment

In severe hepatic impairment and/or biliary obstruction, monitor cefoperazone levels; total daily cefoperazone dose should not exceed 4 g due to predominant biliary excretion.

Geriatric

No specific dose adjustment solely based on age. Consider age-related decrease in renal function.

Max dose

Cefoperazone: 8 g/day; Sulbactam: 4 g/day.

• Hypersensitivity to cefoperazone, sulbactam, other cephalosporins, penicillins, or any component of the formulation.
• History of severe hypersensitivity reaction to any other beta-lactam antibacterial agent.