zostum 250 mg/250 mg injection - Cefoperazone (250mg) + Sulbactam (250mg) medicine

Fytobact 250 mg/250 mg Injection: Complete Medicine Guide

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🏭 Zuventus Healthcare Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 26, 2026
⚠️ Hepatotoxicity Risk 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Well-established for approved indications.
Reviewed by
SaathiMed Expert Panel | Sep 26, 2026
🩺
Medically Fact-Checked & Clinically Verified by SaathiMed Clinical Review Board
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026

When to Call Your Doctor IMMEDIATELY

  • Difficulty breathing or swelling of the face, lips, or throat
  • Severe rash, blistering, or peeling skin
  • Severe or bloody diarrhoea
  • Unusual bleeding or bruising
  • Decreased urine output or swelling in the legs
  • Yellowing of the skin or eyes
  • High fever with chills

If experiencing severe symptoms, call emergency services immediately.

What is zostum 250 mg/250 mg injection used for?

This medicine is a combination antibiotic injection containing cefoperazone and sulbactam. It is used to treat serious bacterial infections. It works by killing bacteria and is given by a healthcare professional.

  • Generic Name: Cefoperazone (250mg) + Sulbactam (250mg)
  • Manufacturer: Zuventus Healthcare Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 zostum 250 mg/250 mg injection के बारे में (Hindi Summary)

उपयोग: यह दवा सेफोपेराज़ोन और सल्बैक्टम का संयोजन है, जिसे इंजेक्शन के रूप में दिया जाता है। यह गंभीर बैक्टीरियल संक्रमणों जैसे निमोनिया, मूत्र मार्ग संक्रमण, पेट के अंदर के संक्रमण, त्वचा संक्रमण और रक्त संक्रमण के इलाज के लिए उपयोग की जाती है। यह दवा बैक्टीरिया को मारकर काम करती है और इसे डॉक्टर या नर्स द्वारा ही दिया जाना चाहिए।

साइड इफेक्ट्स: आम दुष्प्रभावों में दस्त, जी मिचलाना, उल्टी, पेट दर्द, चकत्ते, खुजली और इंजेक्शन लगाने की जगह पर दर्द या सूजन शामिल हैं। गंभीर दुष्प्रभाव दुर्लभ हैं लेकिन इनमें तेज एलर्जी, त्वचा पर गंभीर प्रतिक्रिया, और आंतों का गंभीर संक्रमण शामिल हो सकता है। कोई भी असामान्य लक्षण होने पर तुरंत डॉक्टर को बताएं।

सुरक्षा सलाह: यह दवा केवल योग्य स्वास्थ्यकर्मी द्वारा ही दी जानी चाहिए। इससे पहले कि आपको यह दवा दी जाए, अपनी सभी एलर्जी और किडनी या लीवर की समस्याओं के बारे में डॉक्टर को बताएं। गर्भावस्था या स्तनपान के दौरान डॉक्टर से सलाह लें। इलाज के दौरान शराब न पिएं। कोई भी नया लक्षण जैसे गंभीर दस्त, चकत्ते या सांस लेने में कठिनाई होने पर तुरंत डॉक्टर को सूचित करें।

💡 Did You Know? Over 80% of the antiretroviral drugs used globally to combat AIDS are supplied by Indian pharmaceutical companies.

💊 zostum 250 mg/250 mg injection Uses & Benefits

[{"condition":"Community-acquired pneumonia","description":"Used to treat moderate to severe bacterial pneumonia caused by susceptible organisms.","evidence":"Well-established"},{"condition":"Complicated urinary tract infections","description":"Effective against many gram-negative bacteria causing pyelonephritis and complicated UTIs.","evidence":"Well-established"},{"condition":"Intra-abdominal infections","description":"Used in combination with other antibiotics for peritonitis, abscesses, and biliary tract infections.","evidence":"Well-established"},{"condition":"Skin and soft tissue infections","description":"Treats cellulitis, wound infections, and abscesses caused by susceptible bacteria.","evidence":"Well-established"},{"condition":"Bloodstream infections (septicemia)","description":"Used for bacteremia caused by susceptible gram-negative and gram-positive organisms.","evidence":"Well-established"},{"condition":"Gynecological infections","description":"Used for pelvic inflammatory disease and endometritis when caused by susceptible bacteria.","evidence":"Well-established"}]

Off-label uses: [{"condition":"Febrile neutropenia","description":"Sometimes used as empirical therapy in cancer patients with fever and low white blood cell counts, though not specifically approved for this indication.","evidence":"Limited"},{"condition":"Surgical prophylaxis","description":"Occasionally used before certain surgeries to prevent infection, but not a standard first-line choice.","evidence":"Limited"}]

Primary treatment for: Bacterial infections caused by susceptible organisms.

Also treats: Pneumonia, Urinary tract infections, Intra-abdominal infections, Skin infections, Septicemia

📋 Drug Information

Generic Name(s)Cefoperazone (250mg) + Sulbactam (250mg)
Brand Namezostum 250 mg/250 mg injection
ManufacturerZuventus Healthcare Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassANTI INFECTIVES
Action Class
Route of AdministrationParenteral (intravenous or intramuscular injection)
StorageStore the dry powder at room temperature (15-30°C) in a dry place, protected from light. After reconstitution, the solution should be used immediately or stored as directed by the pharmacist. Do not freeze.
Shelf Life24 months from the date of manufacture, unless otherwise specified on the packaging.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Always check for allergies to penicillins or cephalosporins before administering this medicine.
2
Administer the injection slowly over 30 minutes to 2 hours to reduce the risk of infusion reactions.
3
Monitor renal and liver function tests during prolonged therapy.
4
Watch for signs of superinfection, such as oral thrush or new fever, during treatment.
5
Advise patients to avoid alcohol during and for a few days after treatment.
6
Ensure adequate hydration to help prevent kidney problems.
7
Use with caution in elderly patients and those with kidney impairment.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
Fever with chills
This medicine is used for serious bacterial infections that cause fever.
Likely Use
✅
Burning urination
It is used for urinary tract infections.
Likely Use
❌
Common cold
This medicine is not effective against viral infections.
Not Primary
❌
Headache
This medicine is not a pain reliever.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionNot applicable. This medicine is administered parenterally and is completely bioavailable after intravenous or intramuscular injection.
DistributionCefoperazone distributes widely into body tissues and fluids, including bile, urine, sputum, and peritoneal fluid. Sulbactam also distributes into many tissues. Protein binding of cefoperazone is high (about 90%), while sulbactam binding is lower (about 38%).
Protein BindingCefoperazone: approximately 90%. Sulbactam: approximately 38%.
MetabolismCefoperazone is primarily excreted unchanged in bile and urine, with minimal metabolism. Sulbactam is also largely excreted unchanged in urine.
Half-LifeCefoperazone: approximately 1.5 to 2.5 hours. Sulbactam: approximately 1 hour. Half-life may be prolonged in patients with renal or hepatic impairment.
ExcretionCefoperazone is excreted mainly in bile (about 70%) and urine (about 30%). Sulbactam is excreted primarily in urine (about 75-85%).
Bioavailability100% (intravenous route).
Onset of ActionRapid; bacterial killing begins within 30 minutes to 1 hour after intravenous administration.
Peak Plasma TimeImmediately after intravenous injection; peak serum concentrations occur at the end of infusion.
Duration of ActionBactericidal levels typically persist for 6 to 12 hours, depending on the dose and susceptibility of the organism.

How It Works

This medicine combines two active ingredients. Cefoperazone is a third-generation cephalosporin that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to bacterial death. Sulbactam is a beta-lactamase inhibitor that protects cefoperazone from destruction by certain beta-lactamase enzymes produced by bacteria. Together, they extend the antibiotic's spectrum to cover many beta-lactamase-producing organisms.

Mechanism Steps

1
Cefoperazone binds to penicillin-binding proteins: Cefoperazone attaches to specific PBPs on the bacterial cell membrane, inhibiting the cross-linking of peptidoglycan chains.
2
Inhibition of cell wall synthesis: This blockade weakens the bacterial cell wall, making it susceptible to osmotic lysis.
3
Sulbactam inhibits beta-lactamase enzymes: Sulbactam irreversibly binds to certain beta-lactamase enzymes, preventing them from breaking down cefoperazone.
4
Bacterial cell death: The combined effect leads to bacterial lysis and death, especially for organisms that would otherwise be resistant to cefoperazone alone.

💡 How to Take zostum 250 mg/250 mg injection

Strength: Each vial contains cefoperazone sodium equivalent to 250 mg cefoperazone and sulbactam sodium equivalent to 250 mg sulbactam.

1This medicine is given by a healthcare professional as an intravenous or intramuscular injection.
2For intravenous use, the powder is reconstituted with sterile water or saline and administered slowly over 30 minutes to 2 hours.
3For intramuscular use, it is injected into a large muscle such as the buttock.
4Do not self-administer this injection.
5Follow your doctor's instructions regarding the duration of treatment.
6Complete the full course even if you feel better.

Dosage Information

Adult DosageThe usual adult dose ranges from 1 to 2 grams of cefoperazone combined with 1 to 2 grams of sulbactam every 12 hours, depending on the severity and type of infection. For severe infections, the dose may be increased to 4 grams of cefoperazone with 4 grams of sulbactam per day divided every 12 hours. The maximum recommended daily dose is 8 grams of cefoperazone with 8 grams of sulbactam. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician for appropriate dosing in children.
Elderly DosageElderly patients may have reduced renal function, which can increase the risk of side effects. Dose adjustment may be necessary based on kidney function. Use with caution and monitor renal function.
Renal ImpairmentIn patients with renal impairment (creatinine clearance less than 30 mL/min), dose adjustment may be required. For cefoperazone, no adjustment is needed for mild to moderate renal impairment, but for sulbactam, dose reduction is recommended. Consult a doctor for specific dosing.
Hepatic ImpairmentIn patients with hepatic impairment, cefoperazone elimination may be prolonged. Dose adjustment may be necessary. Monitor liver function closely.
Maximum Daily DoseThe maximum recommended daily dose is 8 grams of cefoperazone with 8 grams of sulbactam, divided into two doses.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

Alcohol
Avoid
May cause disulfiram-like reaction.
Any food
No restrictions
Parenteral administration bypasses digestion.

⏰ What to Do If You Miss a Dose

📌 You miss a scheduled dose at the hospital or clinic
→ Inform your nurse or doctor immediately.
💡 They will reschedule the dose as soon as possible.
📌 You are receiving treatment at home via a home healthcare service
→ Contact your healthcare provider to reschedule.
💡 Do not attempt to self-administer an extra dose.

⚠️ Side Effects of zostum 250 mg/250 mg injection

✅ Common Side Effects

Diarrhoea (Common (1-10%))
Stay hydrated. If diarrhoea is severe or persistent, contact your doctor.
Nausea and vomiting (Common (1-10%))
Inform your doctor if it interferes with eating or drinking.
Injection site pain or inflammation (Common (1-10%))
Apply a cold compress if advised. Report severe pain or swelling.
Rash (Uncommon (0.1-1%))
Report to your doctor. Stop the injection if rash is widespread or accompanied by other symptoms.
Elevated liver enzymes (Uncommon (0.1-1%))
Your doctor may monitor liver function tests during treatment.

🚨 Serious Side Effects

Anaphylaxis (Rare (<0.1%))
Seek emergency medical help immediately if you experience difficulty breathing, swelling of face or throat, or a sudden drop in blood pressure.
Stevens-Johnson syndrome (Rare (<0.1%))
Stop the medicine and seek immediate medical attention if you develop a painful rash, blisters, or peeling skin.
Clostridioides difficile-associated diarrhoea (Rare (<0.1%))
Contact your doctor if you develop severe, watery, or bloody diarrhoea, even weeks after finishing the antibiotic.
Severe blood disorders (e.g., agranulocytosis, thrombocytopenia) (Rare (<0.1%))
Report unusual bruising, bleeding, or signs of infection such as fever and sore throat.
Seizures (Rare (<0.1%))
Seek immediate medical attention if seizures occur, especially in patients with kidney problems.

⚠️ Rare Side Effects

Interstitial nephritis
Report decreased urine output, swelling, or blood in urine.
Hemolytic anemia
Seek medical attention for unexplained fatigue, jaundice, or dark urine.
Pseudomembranous colitis
Report persistent diarrhoea or abdominal cramps.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Warfarin Major
Gentamicin Major
Furosemide Major
Probenecid Moderate
Oral contraceptives Moderate
Methotrexate Moderate
Antacids Minor
Iron supplements Minor
Alcohol Moderate
Other antibiotics Variable

🚨 Major Interactions

  • Warfarin
  • Aminoglycosides (e.g., gentamicin, amikacin)
  • Loop diuretics (e.g., furosemide)

⚡ Moderate Interactions

  • Probenecid
  • Oral contraceptives
  • Methotrexate

🍷 Alcohol Interaction

Avoid alcohol while receiving this medicine. Alcohol may worsen side effects such as nausea, vomiting, and may increase the risk of a disulfiram-like reaction (flushing, headache, palpitations).

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Known severe allergy to cefoperazone, sulbactam, or any other cephalosporin or beta-lactam antibiotic.","Previous history of severe immediate hypersensitivity reaction to penicillins or cephalosporins.","Use in patients with a history of anaphylaxis to beta-lactam antibiotics."]

⚠️ Warnings & Precautions

["Before starting therapy, ask about previous allergic reactions to antibiotics.","Use with caution in patients with kidney or liver impairment; dose adjustment may be needed.","Prolonged use may lead to overgrowth of non-susceptible organisms, including fungi.","May cause false-positive results in urine glucose tests using copper reduction methods.","Avoid alcohol during treatment due to risk of disulfiram-like reaction.","Ensure adequate hydration during treatment.","Monitor for signs of bleeding, especially in patients on anticoagulants."]

🤱 Lactation Safety

Cefoperazone and sulbactam are excreted in small amounts in breast milk. Consult your doctor before breastfeeding while on this medicine. The benefits should be weighed against potential risks to the infant.

💊 Overdose Management

Overdose with this medicine is unlikely due to its parenteral administration by healthcare professionals. In case of accidental overdose, treatment should be symptomatic and supportive. Cefoperazone and sulbactam can be removed by hemodialysis, which may be considered in severe cases. Contact a poison control center or emergency department immediately if overdose is suspected.

⏰ Missed Dose

Since this medicine is given by a healthcare professional, missed doses are unlikely. If you miss a scheduled dose, contact your doctor or nurse as soon as possible to reschedule. Do not attempt to self-administer an extra dose.

Additional Safety Advice

General Safety

This medicine must only be given by a qualified healthcare professional in a setting where emergency treatment for allergic reactions is available. Before receiving this medicine, tell your doctor about all your allergies, especially to antibiotics, and about any kidney or liver problems. Inform your doctor if you are pregnant, planning pregnancy, or breastfeeding. Do not attempt to self-administer this injection. Complete the full course as prescribed, even if you feel better, to prevent resistance. Avoid alcohol during treatment as it may worsen side effects. Report any new symptoms such as severe diarrhoea, rash, or difficulty breathing immediately.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients are more likely to have reduced kidney function, which can increase the risk of side effects. Dose adjustment may be needed. Monitor renal function closely.

🤰 Pregnancy Planning (TTC)

If you are planning pregnancy, consult your doctor before starting this medicine. It should only be used if clearly needed. Discuss the risks and benefits with your healthcare provider.

🏥 Post-Surgery Considerations

This medicine is often used after surgery to prevent or treat infections. Follow your surgeon's instructions carefully. Report any signs of infection like fever, redness, or discharge.

🦷 Dental Procedures

Inform your dentist if you are receiving this medicine. It may interact with other medications used during dental procedures. Your dentist may need to coordinate with your doctor.

💚 Lifestyle Tips for Better Results

🏃
Stay well hydrated to help your kidneys flush out the medicine.
🥗
Eat a balanced diet to support your immune system.
😴
Get plenty of rest to help your body fight the infection.
💧
Avoid alcohol during treatment.
🧘
Practice good hygiene to prevent new infections.
🌞
Complete the full course of antibiotics as prescribed.

🏋️ Exercise Considerations

Avoid strenuous exercise while you are recovering from a serious infection. Light activity like walking is fine if you feel up to it. Consult your doctor before resuming intense workouts.

🥗 Diet Recommendations

Drink plenty of water
Include probiotic-rich foods like yogurt if approved by your doctor
Eat light, easily digestible meals if you have nausea
Avoid alcohol

💼 Impact on Daily Work & Life

You may need to take time off work or school while receiving this medicine, especially if you are hospitalized. It may cause dizziness or fatigue, so avoid driving or operating heavy machinery until you know how it affects you.

🛑 When to Stop This Medicine

Do not stop this medicine without your doctor's advice. Stopping early can lead to treatment failure and antibiotic resistance. Your doctor will decide when to stop based on your clinical response and test results.

📅 Long-Term Use Effects

Long-term use of this medicine may lead to antibiotic resistance, superinfections, and changes in kidney or liver function. It is generally used for short courses. Prolonged use should be monitored with regular blood tests. If you need long-term therapy, your doctor will assess the risks and benefits.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Other antibiotics

Depending on the bacteria and its sensitivity, other antibiotics like ceftriaxone, piperacillin-tazobactam, or carbapenems may be used.

Evidence: Well-established
Supportive care

Rest, hydration, and fever control are important alongside antibiotics.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

There are no specific vaccine interactions with this medicine. However, if you are due for any vaccines, inform your doctor. Live vaccines should be avoided during acute infection.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not freeze

✅ DO

Keep in original packaging

❌ DON'T

Do not use if solution is discolored or contains particles

✅ DO

Use reconstituted solution immediately

❌ DON'T

Do not store reconstituted solution for long periods

✈️ Traveling with This Medicine

This medicine is given in a healthcare setting, so travel is not applicable. If you are traveling after treatment, carry a copy of your prescription and medical records. Store any remaining medication as directed. If you need treatment while traveling, inform the local doctor about your recent antibiotic use.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 60-year-old man with diabetes and a severe urinary tract infection
He was admitted to the hospital and started on this medicine intravenously. His fever subsided within 48 hours, and his urine culture cleared after 5 days of treatment. He was advised to complete the full course and monitor his kidney function.
💡 Lesson: This medicine is effective for serious infections but requires hospital monitoring and completion of the full course.
👤 A 35-year-old woman with a post-surgical abdominal infection
After surgery, she developed fever and abdominal pain. She was given this medicine along with other supportive care. Her symptoms improved gradually, and she was discharged after 7 days. She was cautioned to avoid alcohol and to report any diarrhoea.
💡 Lesson: Combination antibiotics like this are often used for post-surgical infections, but patients must be monitored for side effects.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: This medicine starts working within 30 minutes to 1 hour after administration, but you may not feel better for 1-2 days. Complete the full course as prescribed.

Q: Can I take this medicine at home?

A: No, this medicine must be given by a healthcare professional in a clinical setting due to the risk of serious allergic reactions.

Q: What should I do if I experience side effects?

A: Report any side effects to your doctor immediately. Mild side effects like nausea may resolve, but severe symptoms like difficulty breathing require emergency care.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine if I am allergic to penicillin?
  • Will this medicine affect my kidney function?
  • Can I drive after receiving this injection?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while on this medicine?

🔄 Substitutes for zostum 250 mg/250 mg injection

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can cure viral infections like the flu.
    Fact: This medicine is an antibiotic and only works against bacterial infections. It is not effective against viruses.
  • Myth: You can stop the injection once you feel better.
    Fact: You must complete the full course as prescribed to prevent the infection from returning and to avoid antibiotic resistance.
  • Myth: This medicine is safe to self-administer at home.
    Fact: This medicine must only be given by a healthcare professional in a clinical setting due to the risk of serious allergic reactions.

🔄 Alternative Options

Generic Alternatives

  • Cefoperazone and sulbactam injection (generic versions available)

Brand Alternatives

  • Fytobact 250 mg/250 mg injection

📊 Comparison with Similar Medicines

[{"medicine":"Cefoperazone + Sulbactam","composition":"Cefoperazone 250 mg + Sulbactam 250 mg","route":"Parenteral","primary_use":"Serious bacterial infections"},{"medicine":"Cefoperazone + Tazobactam","composition":"Cefoperazone 500 mg + Tazobactam 500 mg","route":"Parenteral","primary_use":"Serious bacterial infections"},{"medicine":"Ceftriaxone + Sulbactam","composition":"Ceftriaxone 500 mg + Sulbactam 500 mg","route":"Parenteral","primary_use":"Serious bacterial infections"}]

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