Cefoperazone, a bactericidal antibiotic, inhibits bacterial cell wall synthesis of actively dividing cells by binding to one or more penicillin binding proteins (PBPs). Sulbactam is a β-lactamase inhibitor and acts primarily by irreversible inactivation of β-lactamases.

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Rash, skin reactions, fever, eosinophilia, urticaria, and pruritus. Haematological - Slight decreases in Hb conc and haematocrit value. GI effects, diarrhoea or loose stools, nausea, and vomiting. Mild, transient elevations of serum SGOT, SGPT, and alkaline phosphatase concentrations. Renal effects - Transient elevations in BUN and serum creatinine concentrations.

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Pregnancy, lactation

With aminoglycosides: Concomitant admin may increase risk of nephrotoxicity.

With heparin/warfarin: Concurrent use may cause marked hypoprothrombinemia and/or prolonged bleeding time.

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Intravenous
Meningitis, Respiratory tract infections, Skin and soft tissue infections, Intra-abdominal infections, Urinary tract infections, Septicaemia, Bone and joint infections, Gynaecological infections

Adult: Ratio of sulbactam:cefoperazone is 1:1. Doses are expressed in terms of cefoperazone.
Mild to moderate infections: 1-2 g daily, given in equally divided doses every 12 hours.
Severe infections: Up to 4 g daily, given in equally divided doses every 12 hours; max dose of sulbactam: 4 g daily.

Child: Ratio of sulbactam:cefoperaone is 1:1. Doses are expressed in terms of cefoperazone.
Recommended doses: 20-40 mg/kg/day, given in equally divided doses every 6-12 hours.
For serious infections: Up to 160 mg/kg/day, given in 2-4 equally divided doses may be used.
Max dose of sulbactam: 80 mg/kg/day
Renal impairment: Dose adjustments may be needed.

Reconstitution
For IV infusion, each vial should be reconstituted with suitable amount of sterile water for injection, normal saline, 5% dextrose in water, and then diluted to 20 ml using the same diluent followed by admin over 15-60 minutes. For IV injection, each vial should be reconstituted as above and given over at least 3 minutes.

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Hypersensitivity. Known allergy to penicillins

Intravenous
Before reconstitution: Store below 25°C.
Reconstituted solutions are stable for 7 days at 2-8°C and for 24 hours at 8-25°C. All unused portions after the above stated time periods should be discarded.

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