Select a medication above to begin.
Xacduro
sulbactam and durlobactam
Adult Dosing .
Dosage forms: convenience pack
Special Note
- [convenience pack components]
- Info: pack contains sulbactam 1 g vial x1 and durlobactam 0.5 g vial x2
- [strength clarification]
- Info: 1 dose = sulbactam 1 g + durlobactam 1 g
pneumonia, hospital-acquired or ventilator-assoc.
- [1 dose IV q6h x7 days]
- Info: due to Acinetobacter baumannii-calcoaceticus complex; may extend duration based on clinical response; refer to IDSA guidelines; give 1 dose IV q4h if CrCl >130
renal dosing
- [see below]
- CrCl >130: 1 dose q4h; CrCl 45-129: 1 dose q6h; CrCl 30-44: 1 dose q8h; CrCl 15-29: 1 dose q12h; CrCl <15: 1 dose q24h, start 1 dose q12h x3 doses
- HD: 1 dose q24h, start 1 dose q12h x3 doses, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: not defined
hepatic dosing
- [no adjustment]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- caution: hypersensitivity to beta-lactams
- caution: CrCl >130
- caution: renal impairment
- caution: abx-associated colitis hx, recent
Drug Interactions .
Overview
durlobactam
beta-lactamase inhibitor
-
None
sulbactam
beta-lactam antibiotic; beta-lactamase inhibitor
- OAT1 substrate
- alters GI flora
- impairs immunomodulatory bacterial infective agent
Avoid/Use Alternative
- cabotegravir
- cholera vaccine, live
- dichlorphenamide
- fecal microbiota, live
- fexinidazole
- methotrexate
- nitisinone
- probenecid
- trimethoprim
- typhoid vaccine, live
Monitor/Modify Tx
- warfarin
Caution Advised
- lactulose
- sodium picosulfate
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- anaphylaxis
- C. difficile-assoc. diarrhea
Common Reactions
- LFTs incr.
- diarrhea
- anemia
- hypokalemia
- thrombocytopenia
- constipation
Safety/Monitoring .
Monitoring Parameters
Cr at baseline; CBC, LFTs if prolonged tx
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no known risk of fetal harm based on human data w/ sulbactam; no human data available w/ durlobactam; possible risk of skeletal variations based on animal data at 2x and 4x MRHD w/ durlobactam
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no known risk of infant harm based on limited human data w/ sulbactam; no human data available to assess risk of infant harm w/ durlobactam; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for sulbactam: minimal; CYP450: none; for durlobactam: minimal; CYP450: none
Excretion: for sulbactam: urine (75-85% unchanged); Half-life: 2.2h; for durlobactam: urine (78% unchanged); Half-life: 2.5h
Subclass: Beta-Lactamase Inhibitors ; Beta-Lactams
Mechanism of Action
sulbactam binds to peptidoglycan, inhibiting cell wall synthesis in Acinetobacter baumannii-calcoaceticus complex; durlobactam inhibits beta-lactamases, preventing beta-lactam degradation
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.