— Product

CARIZONE-S 1.5GM INJ

CEFOPERAZONE 1 GM + SULBACTUM 0.5GM

CARIZONE-S 1.5GM INJ is an injection of cefoperazone 1 g with sulbactam 0.5 g, a third-generation cephalosporin with a beta-lactamase inhibitor, at the higher cefoperazone strength. It is used in hospital for serious intra-abdominal, biliary, respiratory, urinary, gynaecological and skin infections, and for septicaemia.

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Benefits

The 2:1 ratio delivers a higher cefoperazone dose for more severe infection while keeping the sulbactam load appropriate.
Sulbactam inhibits beta-lactamase, restoring activity against resistant Gram-negative organisms and adding cover against Acinetobacter.
Broad Gram-negative cover including Pseudomonas aeruginosa, with useful anaerobic activity.
High biliary concentration makes it particularly useful in biliary tract infection.
Suited to polymicrobial intra-abdominal and pelvic infection where aerobes and anaerobes coexist.

Side effects

Not everyone gets these. Most are mild and settle as the course finishes.

Common

Pain or induration at the injection site
Diarrhoea or loose stools
Nausea or vomiting
Skin rash

Less common

Raised liver enzymes on testing
Prolonged prothrombin time
Low white cell or platelet count with prolonged therapy
Fever or eosinophilia

Stop and get medical help if any of these occur

Swelling of the face, lips or tongue, difficulty breathing, or collapse
Unusual bruising or bleeding, or bleeding from the gums or injection sites
Severe, watery or bloody diarrhoea during or in the weeks after the course
Widespread rash with blistering or peeling skin
Flushing, sweating, headache and rapid heartbeat after alcohol

Precautions

Cefoperazone can prolong the prothrombin time and cause bleeding, particularly in the malnourished, the elderly, and in renal or hepatic impairment. Monitor prothrombin time; vitamin K is often required.
Causes a disulfiram-like reaction with alcohol — avoid alcohol during treatment and for several days after.
Contraindicated in known cephalosporin allergy; use with caution in penicillin allergy and avoid entirely after penicillin anaphylaxis.
Dose adjustment is needed in significant hepatic impairment or biliary obstruction rather than in renal impairment.
For administration by a qualified healthcare professional only.
Do not mix in the same syringe or line as an aminoglycoside.
Monitor blood counts and liver function during prolonged courses.
Reserve for serious infection and de-escalate on culture results to limit resistance.