From the Guidelines
Cefoparazone-sulbactam is recommended for the treatment of multidrug-resistant infections, with a suggested dosage of cefoperazone 1.5 g/sulbactam 1.5 g every 6 hours, as this combination has shown in vitro synergistic activity and a higher clinical response rate compared to monotherapy 1. The combination of cefoparazone and sulbactam is effective against a wide range of bacteria, including beta-lactamase producing strains, due to the beta-lactamase inhibiting properties of sulbactam. Key considerations for the use of cefoparazone-sulbactam include:
- Local antimicrobial susceptibility and MIC
- Patient renal and hepatic function
- Comorbidities
- Potential side effects, such as hypersensitivity reactions and gastrointestinal disturbances High dose sulbactam of 6-9 g per day has been recommended as an alternative choice for treatment of CRAB infections, and clinicians should consider all clinically relevant factors when deciding on a treatment regimen 1. The treatment duration should be individualized based on the type and severity of the infection, with continuation until the patient has been afebrile and clinically improved for at least 48-72 hours. Common indications for cefoparazone-sulbactam include complicated intra-abdominal infections, pneumonia, urinary tract infections, skin and soft tissue infections, and sepsis. It is essential to monitor patients for potential side effects and adjust the dosage accordingly, particularly in patients with hepatic impairment, as cefoperazone is primarily eliminated through the liver 1.
From the Research
Recommended Use of Cefoparazone and Sulbactam Combination
- The combination of Cefoparazone and Sulbactam is recommended for the treatment of intra-abdominal infections, as shown in a systematic review and meta-analysis 2.
- It is also effective for the treatment of moderate-to-severe bacterial infections, including those caused by beta-lactamase-producing organisms 3.
- The combination has been shown to be effective in the treatment of urinary tract infections, with a cure rate of 57% at one week after treatment 4.
Dosage of Cefoparazone and Sulbactam Combination
- The recommended dosage of Cefoparazone and Sulbactam is 2-4 g/day, administered in evenly divided doses every 12 hours by a 30-minute intravenous drip 3.
- In the treatment of intra-abdominal infections, the dosage can range from 2-8 g/day 5.
- The pharmacokinetics of Cefoparazone and Sulbactam have been evaluated in elderly patients, with mean estimates of Cefoparazone maximal concentration in plasma (Cmax) and area under the curve of drug concentration in plasma versus time (AUC) of 297.5 micrograms/ml and 1247 micrograms.h/ml, respectively, on day 1 of treatment 6.
Efficacy and Safety of Cefoparazone and Sulbactam Combination
- The combination of Cefoparazone and Sulbactam has been shown to be effective and safe for the treatment of intra-abdominal infections, with a clinical efficacy rate of 87.7% and a microbiologic eradication rate of 85% 2.
- The combination has also been shown to be effective and safe for the treatment of moderate-to-severe bacterial infections, with an overall efficacy rate of 95% and a bacterial eradication rate of 85% 3.
- The incidence of treatment-related adverse events was 6.5% in patients treated with Cefoparazone and Sulbactam, compared to 16.4% in patients treated with a comparator regimen 5.