Unasyn Tab: Adults (Including Elderly Patients):
Recommended Dose: 375-750 mg twice daily.
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.
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 10 days treatment for any infection caused by haemolytic Streptococci to prevent the occurrence of acute rheumatic fever or glomerulonephritis.
Children and Infants:
The dosage for most infections in children weighing <30 kg is sultamicillin 25-50 mg/kg/day orally 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.
Patients with Renal Impairment:
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 in such patients should be administered less frequently in accordance with usual practice for ampicillin.
Sulbactam sodium/ampicillin sodium IM/IV can be administered by either IV or IM routes. The following dilutions may be used: See Table 1.
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For IV administration, sulbactam sodium/ampicillin sodium IM/IV should be reconstituted with sterile water for injection or any compatible solution. (See Instructions for Use under Cautions for Usage.) To ensure complete dissolution, allow foaming to dissipate in order to visually inspect. The dose can be given by bolus injection over a minimum of 3 min or can be used in greater dilutions as an IV infusion over 15-30 min. Pfizer sulbactam sodium/ampicillin sodium parenteral 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 sulbactam sodium/ampicillin sodium IM/IV is 1.5-12 g/day in divided doses every 6 or 8 hrs up to a maximum daily dosage of sulbactam of 4 g. Less severe infections may be treated on an every 12-hr schedule. (See Table 2.)
Click on icon to see table/diagram/image
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 treating patients on restricted sodium intake, it should be noted that 1500 mg of sulbactam sodium/ampicillin sodium IM/IV contains approximately 115 mg (5 mmol) of sodium.
For the prophylaxis of surgical infections, 1.5-3 g of sulbactam sodium/ampicillin sodium IM/IV should be given at induction of anesthesia, which allows sufficient time to achieve effective serum and tissue concentrations during the procedure.
The dose may be repeated every 6-8 hrs; administration is usually stopped 24 hrs after the majority of surgical procedures, unless a therapeutic course of sulbactam sodium/ampicillin sodium IM/IV is indicated.
In the treatment of uncomplicated gonorrhea, sulbactam sodium/ampicillin sodium IM/IV can be given as a single dose of 1.5 g. Concomitant probenecid 1 g orally should be administered in order to prolong plasma concentrations of sulbactam and ampicillin.
Children, Infants and Neonates:
The dosage of sulbactam sodium/ampicillin sodium IM/IV for most infections in children, infants and neonates is 150-300 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 preterms), the recommended dose is 75 mg/kg/day (corresponding to 25 mg/kg/day sulbactam and 50 mg/kg/day ampicillin) in divided doses every 12 hrs.