What is the maximum dose of Sulbactam (Sulfamethoxazole/Amoxicillin combination with a beta-lactamase inhibitor)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 16, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

The maximum dose of sulbactam is 4000 mg/day or 80 mg/kg/day. Sulbactam is typically administered in combination with other antibiotics, such as ampicillin, to enhance its effectiveness against certain bacteria. The dosing frequency and duration of treatment may vary depending on the specific infection being treated and the patient's renal function. According to the most recent guidelines 1, the recommended dose of sulbactam is 50 mg/kg/day IV divided in 2-4 doses, with a maximum dose of 4000 mg/day or 80 mg/kg/day. It is essential to monitor patients for potential adverse effects, such as hypersensitivity reactions and gastrointestinal disturbances, during treatment with sulbactam.

Some key points to consider when administering sulbactam include:

  • The medication is typically administered intravenously, with the dose divided into 2-4 doses per day 1
  • The dose may need to be adjusted in patients with renal impairment, with specific adjustments based on creatinine clearance
  • Sulbactam works as a beta-lactamase inhibitor, protecting the partner antibiotic from enzymatic degradation by certain bacteria, thereby extending the spectrum of activity
  • Monitoring for adverse effects, such as hypersensitivity reactions, gastrointestinal disturbances, and superinfections, is crucial during treatment 1

It is worth noting that the guidelines for sulbactam dosing may vary depending on the specific patient population and the infection being treated. However, based on the most recent and highest-quality evidence 1, the maximum dose of sulbactam is 4000 mg/day or 80 mg/kg/day.

From the FDA Drug Label

The total dose of sulbactam should not exceed 4 grams per day. Pediatric patients weighing 40 kg or more should be dosed according to adult recommendations, and the total dose of sulbactam should not exceed 4 grams per day.

The maximum dose of sulbactam is 4 grams per day 2.

  • This applies to both adult and pediatric patients weighing 40 kg or more.
  • The dose should not exceed this maximum limit.

From the Research

Maximum Dose of Sulbactam

  • The maximum dose of sulbactam is not explicitly stated in the provided studies 3, 4, 5, 6, 7.
  • However, the studies discuss the use of sulbactam in combination with other antibiotics, such as ampicillin, cefoperazone, and piperacillin, for the treatment of various infections 3, 4, 5, 6.
  • The dosing regimens for these combination therapies are not specified in the provided studies, but it is mentioned that cefoperazone/sulbactam can be given twice daily 4.
  • Sulbactam has been shown to have intrinsic activity against certain bacteria, including Acinetobacter baumannii, and may be used as an alternative treatment option for infections due to multiresistant strains 6.
  • The in vitro activities of sulbactam alone or in combination with beta-lactams against various bacteria have been evaluated, but the maximum dose is not reported 5, 6, 7.

Related Questions

What is the mechanism of Antimicrobial Resistance (AMR) involving enzymatic inactivation?
What is the relationship between bacterial lysis and procalcitonin (PCT)?
What is the best initial antibiotic for a patient with a severe infection?
Can Zosyn (piperacillin/tazobactam) be used to treat a patient with a urinary tract infection (UTI) and small bowel obstruction (SBO)?
What is the pharmacological group of ampicillin-sulbactam?
What class of medication is likely to reduce the progression of chronic kidney disease (CKD), death from cardiovascular causes, and hospitalization for heart failure with mid-range ejection fraction in a patient with hypertension, hyperlipidemia, and impaired renal function, currently treated with amlodipine, furosemide, potassium chloride, and atorvastatin?
What is the diagnosis based on the findings of no intracranial hemorrhage, mass, or infarct, with preserved gray-white differentiation and no mass effect, and the presence of a retention cyst/mucosal polyps in the sphenoid sinus?
What is the diagnosis based on the findings of no intracranial hemorrhage, mass, or infarct, with preserved gray-white differentiation and no mass effect, and the presence of a retention cyst/mucosal polyps in the sphenoid sinus?
What is the next step in evaluating a 69-year-old woman with progressive exertional dyspnea, occasional dyspnea at rest, and elevated B-type Natriuretic Peptide (BNP), with a history of hypertension, migraines, and chronic kidney disease, on medications including Atenolol (beta blocker), Furosemide (loop diuretic), Losartan (angiotensin II receptor antagonist), and Spironolactone (aldosterone antagonist), with normal Pulmonary Function Tests (PFTs) and high-resolution Computed Tomography (CT) chest?
What is the next best step to manage a patient with severe hypertension (Blood Pressure 193/95) who has already received lobetalol (20 mg) after initial treatment with lisinopril (40 mg) and metoprolol (100 mg), and presented with abdominal pain?
What is the cause of knee pain and inability to extend the knee?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.