Cefoperazone: A third generation injectable cefalosporin

Cefoperazone a third generation injectable cefalosporin

Name of drug

Cefoperazone is an antibiotic used to treat a variety of bacterial infections. It is one of the most useful antibiotics in severe infections.

Class of Cefoperazone

Cefoperazone belongs to a class of drugs called antibiotics. It is cephalosporin antibiotic. It is a third generation cephalosporin antibiotic. Cephalosporins are a group of semisynthetic antibiotics derived from ‘cephalosporin-C’ obtained from a fungus Cephalosporium.

Cefoperazone Uses

It is used to treat various bacterial infections. It is an antibiotic. It is used to treat the following conditions.

• Urinary tract infections are caused by E. coli and Proteus mirabilis. Severe bacterial urinary tract infections like cystitis and urethritis and kidney infections that are caused by susceptible bacteria on urine culture can be treated with it.
• Lower respiratory tract infections caused by susceptible strains of Streptococcus pneumoniae and H. influenzae can be treated with it. It is good against Staphylococcus aureus too.
• Biliary tract infections caused by various bacteria are susceptible to it. As this drug is mainly excreted by bile it is good for biliary tract infections.
• Meningitis is an infection of meninges that surround the brain. Cefoperazone can be used to treat meningitis infection.
• Pseudomonas infection can be treated with this antibiotic. Cefoperazone, unlike other third generation cephalosporin, is active against pseudomonas infection.
• Osteomyelitis.
• It is useful in acute neutropenic patients.
• Intra-abdominal infections.
• Other uses are bacteremia, pyelonephritis and soft tissue infections caused by various bacteria.

Mechanism of action of cefoperazone

Cefoperazone is a cephalosporin of the third generation. Third generation cephalosporins are highly active against gram negative enterococci. cefoperazone is active against Enterobacteria, Haemophilus influenzae and Streptococcus pyogenes. Most of these bacteria are beta lactamase resistant. It is active against Staphylococcus aureus. It’s strongly active against pseudomonas.

It is susceptible to beta lactamase enzymes produced by the bacteria.

Cefoperazone like other cephalosporins stops bacteria forming their cell wall. It has a bactericidal effect. It gets incorporated in the beta lactam ring and stops formation of beta lactam ring. Beta lactam ring is essential for bacteria to form cell wall structure.

Cefoperazone available as

It is available as injection of strength 0.25 gm, 1 gm and 2 gm.

Cefoperazone Administered as

Cefoperazone is administered at recommended doses as slow intravenous infusion.

Pregnancy use in pregnancy

Studies on rats does not suggest any adverse effect in pregnancy. More studies are needed for use in humans in pregnancy. It is classified as group B by USFDA for use in pregnancy. It should be used with caution only when needed in pregnancy.

Lactation use in lactation

Cefoperazone is an antibiotic that can be safely used in a lactating mother who is breastfeeding her baby.

Still the limited data exist about its use in lactating mothers.

Elderly

Cefoperazone can be safely used in elderly people without any increased side effects in this age group.

Liver failure

Transient rise of various liver enzymes has been observed with use of cephalosporins including it. It should be used cautiously in cases of liver failure.

It is mainly excreted by the liver in the biliary tract. It should be used with caution in liver failure and biliary obstruction cases.

Dose adjustment may be needed as these diseases increase its elimination half life 2-4 fold.

Cefoperazone in Kidney failure

It is mainly excreted by the liver. It can be used in all degrees of renal failure including severe renal failure.

Still the serum levels should be monitored at high doses.

Cefoperazone with alcohol

Alcohol consumption with Cefoperazone may produce disulfiram-like reactions. You should avoid drinking alcohol when you are given this drug. 

In disulfiram-like reactions there is nausea, vomiting, severe abdominal pain, dizziness, headache.

Side effects of Cefoperazone

Like any other medicine cefoperazone too causes side effects. They as as follows:

• Diarrhea is the most common side effect caused by this drug. It can be due to antibiotic associated diarrhea. It can be treated with probiotics and metronidazole.
• Dizziness.
• Fatigue.
• Fever.
• Flatulence.
• Dyspepsia.
• Headache.
• Nausea and vomiting.
• Decreased leukocyte count.
• Pseudomembranous colitis.
• Steven Johnson syndrome.
• Disulfiram like reaction.
• Reduced platelet counts.

Usual drug dosages

Drug dosages and duration depends upon underlying conditions for which it is used.

• Adult dosages: 2-4 gram per day by intravenous injection by slow infusion in 2 divided doses 12 hourly.

• Children: In children it can be used as intravenous injection 50-200 mg/kg/day in 2 divided doses.

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