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 cefoperazone sodium and sulbactam sodium (0.5g+0.5g powder for injection)  
 
Character
This product is white or almost white powder.
Indications
This product is used to treat the following infections caused by sensitive bacteria:
Respiratory tract infections (upper and lower respiratory tract); urinary tract infections (upper and lower urinary tracts); peritonitis, cholecystitis, cholangitis and other intra-abdominal infections; sepsis, meningitis; skin and soft tissue infections, eye infections, Bone and joint infections; pelvic inflammatory disease, endometritis, gonorrhoea, and other genital and tract infections; prevention of post-operative infections caused by celiac, gynecological, cardiovascular, orthopedic, and plastic surgery.
Dosage
Intramuscular or intravenous injection.
The daily dose for adults is calculated as cefoperazone 1 to 2 g, divided equally and injected once every 12 hours. Severe or refractory infection, the daily dose can be increased to 8g, divided into equal amounts, once every 12 hours. However, the total amount of sulbactam should not exceed 4g per day.
Severe renal insufficiency, due to reduced clearance of sulbactam, should be appropriately adjusted dosage regimen. For patients with creatinine clearance between 16 and 30 ml/min, the maximum amount of sulbactam contained in this product per 12 hours must not exceed 1 g; if the creatinine clearance is < 15 ml/min, the amount of sulbactam contained in this product every 12 hours should be included. Must not exceed 0.5g.
Intramuscular injection:
This product is injected into the deep muscle with 4ml (0.75ml with 3ml) of sterile water for injection every 1.5g. If you need to add lidocaine, it should be added after the sterile water for injection is dissolved. Do not dissolve this product directly with lidocaine injection. Otherwise, turbidity or precipitation will occur.
Intravenous injection:
Dissolve 0.75g, 1.5g of this product in 5ml or 2.25g, 3.0g specifications with 10ml sterile water for injection or 0.9% sodium chloride injection, then add this solution to suitable infusion solution for intravenous injection or Drip. Typical infusions that can be used to dilute the product are: 0.9% Sodium Chloride Injection, 5% Glucose Injection, Glucose and Sodium Chloride Injection, and 10% Glucose Injection.
If you are using Ringer's solution, you must dissolve the product with sterile water for injection and slowly add it to Ringer's solution. Otherwise, a milky white precipitate will result.
Adverse reactions
Patients are generally well tolerated with cefoperazone-sulbactam. Most of the adverse reactions were mild or moderate and could be tolerated without affecting continued treatment.
1. Common adverse reactions were diarrhea, loose stools, ALT, AST, ALP and a transient increase in blood bilirubin;
2. Less common adverse reactions (<1%) include: fever, chills, headache, nausea, vomiting, transient pain at the injection site, phlebitis, rash, urticaria, slight neutrophil depletion, hemoglobin Decreased, thrombocytopenia, hypoprothrombinemia, eosinophilia;
3. Long-term use of this product can occur reversible neutropenia;
4. Occasionally anaphylactic shock, Stevens-Johnson syndrome.
Contraindication 
Allergy to penicillin or cephalosporin antibiotics is prohibited.
Precautions
1.Before applying cefoperazone-sulbactam, patients must be asked in detail whether they have previously had a history of allergies to this product, other cephalosporins, penicillins, or other drugs because of beta lactams such as penicillins and cephalosporins. There may be cross-allergic reactions between antibiotics. About 5% to 10% of patients with penicillin antibiotic allergy can cross-sensitize cephalosporins. Therefore, patients with a history of penicillin allergy, when the indication is applied, must be weighed carefully and carefully followed by careful observation. When this product is used, it must be stopped immediately if an allergic reaction occurs. In the event of anaphylactic shock, immediate local emergency treatment is required to give emergency measures such as adrenaline, maintenance of airway patency, oxygen absorption, glucocorticoids, and antihistamines.
2. This product should not be directly dissolved with calcium injections such as Ringer's solution, otherwise it will produce a milky white precipitate; also can not be used to dissolve acidic liquids, because the pH is lower than 4.5, cefoperazone acid may precipitate.
3. This product is formulated with various suitable diluents. It should be used within 24 hours in dark and cool places. Users who exceed this storage time should be discarded and not allowed to use it.
4. Most of cefoperazone is excreted by the hepatobiliary system, so patients with severely reduced liver function need to adjust the dosing regimen when using this product.
5. This product is not transparent after being dissolved. This is due to the low pH of the diluent. It must not be heated and dissolved to avoid drug damage. Dilution can be appropriately increased, or add a small amount of sodium bicarbonate injection solution can be dissolved.
6. Patients with severely reduced renal function need to adjust dosage and dosing interval when using cefoperazone-sulbactam.
7. The cefoperazone-sulbactam sodium prolonged half-life in the elderly with renal dysfunction and liver damage, reduced drug clearance and increased expression volume. Among them, the pharmacokinetic parameters of cefoperazone are closely related to the degree of damage of liver function, and the pharmacokinetic parameters of sulbactam are closely related to the degree of impairment of renal function. Therefore, patients with renal insufficiency and/or impaired liver function need to adjust the dose.
8. Vitamin K deficiency occurs in a small number of patients after treatment with cefoperazone-sulbactam and its mechanism is likely to be related to inhibition of intestinal flora. Patients with malnutrition, malabsorption (such as cystic fibrosis patients) and long-term intravenous high-nutrient preparations and patients receiving anticoagulant therapy should use this product to supplement vitamin K and monitor prothrombin time.
9. It has been reported that during drinking cefoperazone and drinking within 5 days after treatment, patients may cause facial flushing, sweating, headache, and tachycardia. Patients should avoid drinking alcoholic beverages when using this product. Parenteral administration of high-nutrient formulations containing alcoholic ingredients should also be avoided.
10. Both cefoperazone and sulbactam cause positive direct Coombs test.
11. This product has a synergistic effect with the application of aminoglycosides.
12. When cefoperazone-sulbactam is used, false positive reactions may occur when urine sugar is tested with Benidict solution or Fehling reagent.
13. Waste medicine packaging should not be discarded.
Storage 
Closed, kept in a cool and dry place. 
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