Cefoperazone Sulbactam Renal Dose Guide

1. Introduction

Cefoperazone Sulbactam is a combination medicine used to fight bacterial infections. Cefoperazone is an antibiotic that kills bacteria by stopping their growth. Sulbactam helps cefoperazone work better by preventing bacteria from breaking it down. This medicine is commonly used to treat infections like pneumonia, urinary tract infections, and infections in the abdomen.

2. Renal Dosage Adjustments

When someone's kidneys are not working well, it’s important to change the medicine dose to keep them safe. Kidneys help remove medicines from the body, so if they aren’t working right, the medicine can build up and cause problems.

Kidney Problems are Classified as:

• Mild Renal Impairment: Kidneys work a little less well.
• Moderate Renal Impairment: Kidneys work much less well.
• Severe Renal Impairment: Kidneys work very poorly.
• End-Stage Renal Disease (ESRD): Kidneys barely work and the person might need dialysis.
• Dialysis (HD/PD): A treatment that does some of the work kidneys usually do.

3. Standard Adult Dosage

For adults with normal kidney function, the usual dose of cefoperazone sulbactam is:

• For infections: 1 to 2 grams every 12 hours through an IV (a needle into a vein).

4. Renal Dosing Recommendations

a. Mild Renal Impairment (CrCl 60-90 mL/min)

• Dosage Adjustment: May not need to change the dose.
• How Often to Take It: Every 12 hours.
• Notes: Watch for any side effects.

b. Moderate Renal Impairment (CrCl 30-59 mL/min)

• Dosage Adjustment: May not need to change the dose.
• How Often to Take It: Every 12 hours.
• Notes: Make sure to follow the doctor's instructions closely.

c. Severe Renal Impairment (CrCl 15-<30 mL/min)

• Dosage Adjustment: sulbactam 1 gram every 12 hours
• How Often to Take It: Every 12 hours.
• Notes: Only sulbactam will be adjusted in CrCl <30 mL/Min

d. End-Stage Renal Disease (ESRD) (CrCl<15 mL/min)

• Dosage Adjustment: sulbactam 500 mg 
• How Often to Take It: Every 12 hours.
• Dosage for Dialysis Patients:
• Hemodialysis (HD): Take a dose after dialysis sessions.
• Peritoneal Dialysis (PD): Dose timing depends on the dialysis schedule.
• Precautions: Closely monitor kidney function and adjust doses as needed.

5. Paediatric Renal Dosing

For children with kidney problems:

• Dose Adjustment: Based on the child’s weight and how well their kidneys work.
• Special Considerations: Always follow a doctor’s guidance. Sometimes, dose changes are needed to keep the medicine safe.

6. Administration

• How to Take It: Through an IV (a needle in a vein).
• With or Without Food: It doesn’t matter; follow the healthcare provider’s instructions.
• Maximum Dose: Do not take more than what the doctor prescribes.
• Missed Dose: If you miss a dose, take it as soon as you remember. If it’s almost time for the next dose, skip the missed one and continue the regular schedule.
• Overdose: If you think you took too much, contact a doctor right away.

7. Contraindications

Do not take cefoperazone sulbactam if:

• You are allergic to cefoperazone, sulbactam, or other antibiotics in the cephalosporin family.
• You have a history of severe kidney problems without proper dose adjustments.
• Your doctor tells you not to take it due to other health issues.

8. Warnings & Precautions

• Kidney Function Tests: Doctors may check your kidney health regularly while you’re taking this medicine.
• Kidney Problems: Tell your doctor if your kidney issues get worse.
• Drug Interactions: Inform your doctor about all other medicines you are taking, especially those that can harm the kidneys.

9. Adverse Effects in Renal Impairment

Common side effects may include:

• More Likely: Nausea, vomiting, or diarrhea.
• Signs of Too Much Medicine: Feeling very tired, confusion, or unusual swelling.
• Serious Reactions: Severe allergic reactions like rash, itching, or trouble breathing. Seek medical help immediately if these occur.

10. Clinical Pharmacology in Renal Impairment

In people with kidney problems:

• How the Body Handles the Medicine: The kidneys remove cefoperazone sulbactam from the body. If kidneys aren’t working well, the medicine stays longer in the body.
• Effect on Medicine Levels: The amount of medicine in the blood can increase, which is why dose adjustments are necessary to prevent side effects.

11. Patient Education

• Take as Prescribed: Always follow the doctor’s instructions on how and when to take the medicine.
• Watch for Side Effects: Let your doctor know if you feel sick or notice anything unusual.
• Kidney Health: Keep up with kidney tests to ensure the medicine is safe for you.
• Stay Hydrated: Drink enough water unless your doctor says otherwise.
• Diet: Follow any dietary advice your doctor gives you to help your kidneys work well.

12. References

• Pfizer Labeling Information
• National Center for Biotechnology Information (NCBI) Articles
• Drugs.com Dosage Guidelines
• PubMed Clinical Studies
• MIMS Hong Kong Drug Information

Always consult with a healthcare professional before starting or changing any medication.