Hypersensitivity, incl. to penicillins and other cephalosporins.
Nervous system and sensory organs: headache (0.04%).
From the cardiovascular system and blood (Hematopoiesis, hemostasis): hypoprothrombinemia (3.8%), transient eosinophilia (3.5%), decrease in hemoglobin (0.9%) and hematocrit (0.9%), thrombocytopenia (0.8%), reversible neutropenia with long-term treatment (0.5%), leukopenia, hypotension, vasculitis.
On the part of the gastrointestinal organs: diarrhea (3.9%), nausea and vomiting (0.6%), pseudomembranous colitis.
Allergic reactions: maculopapular rash (0.6%), urticaria (0.08%), Stevens-Johnson syndrome, anaphylactoid reaction, incl.shock.
And others: positive Coombs test (5.5%), fever (0.5%), injection pain (0.08%), chills (0.04%), transient increase in ALT levels (6.2%), AST (5.7%), alkaline phosphatase (2.4%) and bilirubin (1.2%), hematuria, itching.
Local reaction: sometimes-pain at the injection site, Phlebitis at the infusion site (0.1%).
Infections of the upper and lower respiratory and urinary tract, skin and soft tissues, BONES and joints, inflammatory diseases of the pelvic organs, genital organs (endometritis, gonorrhea, etc.), intra-abdominal infections (peritonitis, cholecystitis, cholangitis, etc.), sepsis, meningitis.
Infections of the upper and lower respiratory and urinary tract, skin and soft tissues, BONES and joints, inflammatory diseases of the pelvic organs, genital organs (endometritis, gonorrhea, etc.), intra-abdominal infections (peritonitis, cholecystitis, cholangitis, etc.), sepsis, meningitis.
Acebis
Cefoperazone, Sulbactam
In adults, sulbactam / cefoperazone is recommended to use the following daily doses (see table. 1):
Table 1
| Relationship | Sulbactam / cefoperazone (g) | Sulbactam dose (g) | Cefoperazone, dose (g) |
| 1:1 | 2,0-4,0 | 1,0-2,0 | 1,0-2,0 |
The daily dose should be divided into equal parts and administered every 12 hours.
In severe or refractory infections, the daily dose of sulbactam / cefoperazone can be increased to 8 g with a ratio of the main components of 1:1 (i.e. 4 g of cefoperazone). Patients receiving sulbactam / cefoperazone in a 1:1 ratio may require additional administration of cefoperazone. The dose should be divided into equal parts and administered every 12 hours.
The maximum recommended daily dose of sulbactam is 4 G.
Use in violation of kidney function.
In patients with a Cl creatinine of 15 to 30 ml/min, the maximum dose сульбактама is 1 g every 12 hours (maximum daily dose сульбактама 2 g), and in patients with a Cl creatinine of less than 15 ml/min, the maximum dose сульбактама is 500 mg every 12 hours (maximum daily dose сульбактама 1 g). In severe infections, additional administration of cefoperazone may be required.
The pharmacokinetics of sulbactam changes significantly during hemodialysis. You1/2 serum cefoperazone decreases somewhat during hemodialysis. Therefore, the administration of the drug should be planned after dialysis.
Use in children.
In children, sulbactam / cefoperazone is recommended to use the following daily doses (see table. 2):
Table 2
| Relationship | Sulbactam / cefoperazone (mg / kg / day) | Sulbactam, dose (mg / kg / day) | Cefoperazone, dose (mg / kg / day) |
| 1:1 | 40-80 | 20-40 | 20-40 |
The dose should be divided into equal parts and administered every 6-12 hours.
In severe or refractory infections, these doses can be increased to 160 mg/kg/day with a ratio of main components of 1:1. The daily dose is divided into 2-4 equal parts.
Application in newborns.
In newborns during the first week of life, the drug should be administered every hour 12.la the maximum daily dose of sulbactam in children should not exceed 80 mg / kg / day.
Method of preparation of solutions for parenteral use.
In / in introduction.
For the preparation of a solution for intravenous infusion, a Ringer's milky solution can be used, but it can not be used for initial dissolution, so it is recommended to prepare a solution in two stages — the powder is initially dissolved in water for injection, and then diluted with Ringer's milky solution.
For repeated infusions, the contents of each vial of sulbactam / cefoperazone are dissolved in an adequate volume of 5% dextrose solution in water, 0.9% sodium chloride solution for injection or sterile water for injection, and then diluted to 20 ml with the same solvent. Infusion is carried out for 15-60 minutes.
For intravenous injection, the contents of each vial should be dissolved as indicated above and administered for at least 3 minutes.
In / m introduction.
To prepare a solution for intravenous administration, you can use a 2% lidocaine hydrochloride solution, but it can not be used for initial dissolution, so it is recommended to prepare a two — stage solution-the powder is initially dissolved in water for injection, and then diluted with a 2% lidocaine hydrochloride solution.
Preparation of the solution
Table 3
| Total dose (g) | Equivalent doses sulbactam cefoperazone (g) | Solvent volume (ml) | Maximum final concentration (mg / ml) |
| 2 | 1,0 1,0 | 6,7 | 125 125 |
Сульбактам / сефоперазон is compatible with water for injection, 5% dextrose solution, sodium chloride saline solution, 5% dextrose solution in a physiological solution at concentrations of 10 mg/ml сульбактама and 10 mg/ml сульбактама up to 250 mg/ml and 250 mg/ml, respectively.
Ringer's milky solution.
Sterile water for injection should be used to dissolve the powder. The solution is prepared in 2 stages: first, use sterile water for injection (see table. above), then the resulting solution is diluted with Ringer's milky solution to a sulbactam concentration of 5 mg / ml (2 ml of the initial solution diluted in 50 ml of Ringer's milky solution or 4 ml in 100 ml of Ringer's milky solution).
Lidocaine.
Sterile water for injection should be used to dissolve the powder. A solution containing cefoperazone at a concentration of 250 mg/ml or more is prepared in 2 stages: first, use sterile water for injection (see table. 2% lidocaine solution to obtain a solution containing up to 250 mg/ml of cefoperazone and 250 mg/ml of sulbactam in about 0.5% solution of lidocaine hydrochloride.
