Tablet: Adults (including the elderly):
Recommended Dose: 1-2 tabs (375-750 mg) twice daily. The dosage for most infections in children weighing <30 kg is 25-50 mg/kg/day in 2 divided doses depending on the severity of the infection and the physician's judgment. For children weighing >30 kg, the usual adult dose should be given.
In both adults and children, treatment is usually continued until 48 hrs after pyrexia and other abnormal signs have resolved. Treatment is normally given for 5-14 days, but the treatment period may be extended if necessary.
In the treatment of uncomplicated gonorrhoea, sultamicillin can be given as a single oral dose of 2.25 g (six 375-mg tabs). Concomitant probenecid 1 g should be administered in order to prolong plasma concentrations of sulbactam and ampicillin.
Cases of gonorrhoea with a suspected lesion of syphilis should have darkfield examinations before receiving sultamicillin and monthly serological tests for a minimum of 4 months.
It is recommended that there be at least a 10-day treatment for any infection caused by haemolytic streptococci to prevent the occurrence of acute rheumatic fever or glomerulonephritis.
In patients with severe impairment of renal function (creatinine clearance <30 mL/min), the elimination kinetics of sulbactam and ampicillin are similarly affected and hence the plasma ratio of one to the other will remain constant. The dose of sultamicillin in such patients should be administered less frequently in accordance with usual practice for ampicillin.
Bactesyn IM/IV can be administered by either IV or IM routes. The following dilutions may be used: See Table 1.
Click on icon to see table/diagram/image
For IV administration, Bactesyn IM/IV should be reconstituted with sterile water for injection or any compatible solution and allowed to stand to allow any formation to dissipate to permit visual inspection for complete dissolution. The dosage can be given by bolus injection over a minimum of 3 min or can be used in greater dilutions either as a bolus or as an IV infusion over 15-30 min. Bactesyn IM/IV may also be administered by deep IM injection; if pain is experienced, 0.5% sterile solution for injection of anhydrous lignocaine HCl may be used for reconstitution of the powder.
The usual dosage range of Bactesyn IM/IV in adults is 1.5-12 g/day in divided doses every 6-8 hrs up to a maximum daily dosage of sulbactam of 4 g. Less severe infections may be treated on 12-hourly schedule.
Daily Dose of Bactesyn IM/IV: Mild infection:
1.5-3 (0.5 + 1 to 1 + 2) g; moderate infection:
Up to 6 (2 + 4) g; severe infection:
Up to 12 (4 + 8) g.
The dosage of Bactesyn IM/IV for most infections in children, infants and neonates is 150 mg/kg/day (corresponding to sulbactam 50 mg/kg/day and ampicillin 100 mg/kg/day). In children, infants and neonates, dosing is usually every 6 or 8 hrs in accordance with the usual practice for ampicillin. In neonates during the 1st week of life (especially pre-terms), dosing is usually every 12 hrs. More or less frequent dosing may be indicated depending on the severity of the illness and the renal function of the patient. Treatment is usually continued until 48 hrs after pyrexia and other abnormal signs have resolved. Treatment is normally given for 5-14 days, but the treatment period may be extended or additional ampicillin may be administered in severely ill cases.
In patients with severe impairment of renal function (creatinine clearance <30 mL/min), the elimination kinetics of sulbactam and ampicillin are similarly affected and hence, the plasma ratio of one to the other will remain constant. The dose of Bactesyn IM/IV in such patients should be administered less frequently in accordance with the usual practice for ampicillin. In treating patients on restricted sodium intake, it should be noted that Bactesyn 1500 mg IM/IV contains sodium approximately 115 mg (5 mmol).
For the prophylaxis of surgical infections, Bactesyn 1.5-3 g IM/IV should be given at induction of anaesthesia which allows sufficient time to achieve serum and tissue concentrations during the procedure. The dose may be repeated 6-8 hourly; administration is usually stopped 24 hrs after the majority of surgical procedures, unless a therapeutic course on Bactesyn IM/IV is indicated.
Bactesyn may be taken with or without food.