INDICATIONS

Monotherapy or combination therapy for the following indications when caused by susceptible organisms:

• Upper and Lower Respiratory Tract Infections
• Urinary Tract Infections
• Intra-Abdominal Infections (Peritonitis, Cholecystitis, Cholangitis etc)
• Septicemia
• Meningitis
• Skin and Soft Tissue Infections
• Bone and Joint Infections
• Pelvic Inflammatory Disease, Endometritis, Gonorrhea and Other Infections of the Genital Tract.

DOSAGE AND ADMINISTRATION

Adult Dose: 1.5 to 3g per day IV or IM In equally divided doses every 12 hours. Maximum Dose is 12g per day. The recommended maximum daily dosage of Sulbactam is 4g.

Pediatric Dose: 30 to 60 mg/kg/day. Maximum dose is 240mg/kg/day in two or four equally divided doses. The maximum daily dosage of Sulbactam is should not exceed 80mg/kg/day.

Benefits of Cefoperazone/Sulbactam (2:1) Combination...

2:1 Ratio maximized the Cefoperazone spectrum of activity and best approximated the parenteral formulation of the drug.

2:1 Ratio boost the anti-microbial activity against

• Enterobacteriaceae (Klebsiella spp., C. jfieundii, E. aerogenies and E. cloage) etc.
• The mutants derepressed for Type I beta-lactamase. (Pseudomonas aeruginosa).
• Some nonenteric gram-negative organisms resistant to other newer beta-lactams. 2
• Plasmid-mediated beta-lactamases.
• Acinetobacter spp & Bacteroides spp.**

The coverage of gram-negative anaerobes by Cefoperazone was improved from 65 to >99% by adding Sulbactam in a 2:1 ratio." Sulbactam increases the activity of Cefoperazone against the Enterobacteriaceae and nonfermenters to various degrees in a species and concentration- dependent manner and converts many Cefoperazone resistant strains into the susceptible range.

Isolates of Enterobacter spp., C. freundii & Serratia spp. were susceptible to Cefoperazone/Sulbactam. The sensitivities of these organisms against Cefoperazone/Sulbactam were 100%.

A prospective, randomized, controlled trial compared Cefoperazone/ Sulbactam (2:1 Ratio) with Imipenem as empirical monotherapy for Febrile Granulocytopenic patients.

RESULT: Overall, favorable clinical response rates for Cefoperazone / Sulbactam (2:1 ratio) is 88% and Imipenem is 81%.

CONCLUSION: Support the efficacy and safety of either Cefoperazone / Sulbactam or Imipenem as empirical monotherapy for Febrile Granulocytopenic patients.