Sulbactam is able to inhibit the most common forms of beta-lactamase but is not able to interact with the ampC cephalosporinase. Thus, it confers little protection against bacteria such as Pseudomonas aeruginosa, Citrobacter, Enterobacter, and Serratia, which often express this gene.
In the United States, sulbactam is combined to form cefoperazone/sulbactam and ampicillin/sulbactam. It does possess some antibacterial activity when administered alone, but it is too weak to have any clinical importance.
Cefoperazone, a bactericidal antibiotic, inhibits bacterial cell wall synthesis of actively dividing cells by binding to one or more penicillin binding proteins (PBPs). Sulbactam is a β-lactamase inhibitor and acts primarily by irreversible inactivation of β-lactamases.
Rash, skin reactions, fever, eosinophilia, urticaria, and pruritus. Haematological – Slight decreases in Hb conc and haematocrit value. GI effects, diarrhoea or loose stools, nausea, and vomiting. Mild, transient elevations of serum SGOT, SGPT, and alkaline phosphatase concentrations. Renal effects – Transient elevations in BUN and serum creatinine concentrations.
Meningitis, Respiratory tract infections, Skin and soft tissue infections, Intra-abdominal infections, Urinary tract infections, Septicaemia, Bone and joint infections, Gynaecological infections
Adult: Ratio of sulbactam:cefoperazone is 1:1. Doses are expressed in terms of cefoperazone.
Mild to moderate infections: 1-2 g daily, given in equally divided doses every 12 hours.
Severe infections: Up to 4 g daily, given in equally divided doses every 12 hours; max dose of sulbactam: 4 g daily.
Child: Ratio of sulbactam:cefoperaone is 1:1. Doses are expressed in terms of cefoperazone.
Recommended doses: 20-40 mg/kg/day, given in equally divided doses every 6-12 hours.
For serious infections: Up to 160 mg/kg/day, given in 2-4 equally divided doses may be used.
Max dose of sulbactam: 80 mg/kg/day
Renal impairment: Dose adjustments may be needed.