XONEJET S-750 INJ

XONEJET S-750 INJ
Ceftriaxone 500 mg + Sulbactam 250 mg

The bactericidal activity of Sacker-S is due to the Ceftriaxone component and the ability of Ceftriaxone to
interfere with the biosynthesis of the peptidoglycan component of the bacterial cell wall by binding to and
inactivating penicillin-binding proteins (PBPs).

Ceftriaxone induces filamentation in Escherichia coli and Pseudomonas aeruginosa, it binds primarily to PBP
3 which is responsible for formation of cross-wall or septum of dividing bacilli. Ceftriaxone has a high degree
of stability against the beta-lactamases, both penicillinases and cephalosporinases produced by both gram –
ve and gram +ve bacteria but not against chromosornally and plasmid mediated ESBL’s produced by some
strains of Klebsiella, Escherichia coli, Enterobacter spp and Serratia spp.

Sulbactam irreversibly blocks the destruction of beta-lactam ring of Ceftriaxone by these wide variety oi
ESBLs and chromosomally mediated beta-lactamases by attaching to these enzymes and acting as a suicide
substrate that forms a stable intermediate, rendering the enzyme inactive.

Sulbactam is a broader-spectrum beta-lactamase inhibitor than clavulanic acid. Sulbactarn does ram induce
chromosomal beta-lactamases like clavulanic acid, nor does it select for derepressed beta-lactamase-
producing bacteria. Thus the full potential of Ceftriaxone against Klebsiella, pseudomonas. Eschericia coli spp
is restored by addition of Sulbatam.

INDICATIONS

XONEJET-S is indicated for the treatment of following infections when caused by susceptible bacteria.

Meningitis
-For treatment of Nosocomial infections surgical prophylaxis
-Urinary tract infections (complicated by underlying urological abnormalities)
-Skin and soft tissue infections Like cellulites, erysepalis etc.
-Cholecystitis

Osteomyelitis

-Sexually transmitted diseases (Gonorrhoea, Chancroid, Syphilis)
-Chronic suppurative bacterial otitis media
-Infections in dialysis unit

DOSAGE AND ADMINISTRATION

Adults

The usual adult daily dose (in terms of Ceftriaxone) is 1-2 grams given once a day (or in equally divided doses
twice a day) depending on the type and severity of the infection. The total daily dose shoal malt exceed 4
grams.clearance less than 15m1/min patient should receive a maximum of 500mg of sulbactam every 12
hours(maximum dose 1 gram of sulbactam)

Paediatric patients

For treatment of Skin and Soft tissue infections the recommended total daily dose (in terms of Ceftriaxone) is
50-75mg/kg given once a day or (in equally divided doses twice a day). The total daily dose should not exceed
1 gram.

For treatment of acute bacterial otitis media: A single intramuscular dose of 50 mg/kg (not to exceed lgram) is
recommended.

In treatment of Meningitis: The initial therapeutic dose in terms of Ceftriaxone should be 100 mg/kg (not to
exceed 4 grams) Daily dose may be administered once a day or in equally divided doses 12 hourly. The usual
duration of therapy is 7-14 days.

For treatment of serious infections other than meningitis: Recommended total daily dose in terms of
Ceftriaxone is 50-75 mg/kg given in divided doses every 12 hors.

The total daily dose (in terms of Ceftriaxone) should not exceed more than 2 grams.

CLINICAL ADVANTAGES

Sulbactam enhances the antibacterial spectrum of cephalosporins to include bacterial that are otherwise
resistant.
Sulbactam -ceftriaxone combination has demonstrably better clinical success rates than cephalosporins
used alone.
Beta-lactam/beta-lactamase combinations in general yield better clinical outcomes than comparators.
Sulbactam -ceftriaxone combination has the unique properties of a broad spectrum antibiotic with the
added advantage of a wide-spectrum betalactamase inhibitor.