View source for Cefoperazone

==General==
*Type: [[Is Generation::3rd generation]] [[Is DrugClass::Cephalosporin]]
*Dosage Forms: powder for injection
*Dosage Strengths: 1g, 2g, 10g
*Routes of Administration: IV, IM
*Common Trade Names: Cefobid

==Adult Dosing==
===General===
*Mild-Moderate: 1-2g IM/IV q12h
*Severe: 2-4g IM/IV q8h or 3-4g q12h
*Max: 12g/day (total daily dose)

===Pseudomonas pneumonia (HAP/VAP)===
*2g IV q8h or 3g IV q12h
*Often used in combination with another anti-pseudomonal agent

===Complicated [[Intra-abdominal Infections]]===
*2g IV q12h
*Usually combined with metronidazole or used as Cefoperazone/Sulbactam

===Complicated [[UTI]] and Gynecological Infections===
*2g IV q12h

==Pediatric Dosing==
===General===
*Neonates (<8 days): Not recommended
*Infants/Children: 50-200mg/kg/day IM/IV divided q12h
*Max: 12g/day

==Special Populations==
*Pregnancy: B
*Lactation: Low distribution into milk; generally compatible
*Renal
**Adult
***No adjustment necessary for renal impairment alone (primary excretion is biliary)
***Hemodialysis: Schedule dose to follow dialysis
**Pediatric
***No adjustment defined
*Hepatic
**Modification required in severe obstruction or severe hepatic disease
**Max dose 1-2g/day if severe hepatic dysfunction + renal impairment exist

==Contraindications==
*Allergy to class/drug (Cephalosporins)
*History of severe hypersensitivity to penicillin

==Adverse Reactions==
===Serious===
*[[Anaphylaxis]]
*[[Stevens-Johnson Syndrome]]
*[[Clostridium difficile]]
*Hypoprothrombinemia (Bleeding risk due to MTT side chain)
*Disulfiram-like reaction (Alcohol intolerance)

===Common===
*[[Diarrhea]] (Higher incidence than other cephalosporins due to biliary excretion)
*[[Rash]]
*Phlebitis at injection site
*Eosinophilia
*Reversible Neutropenia

==Pharmacology==
*Half-life: 2.0h
*Metabolism: Hepatic (not extensively metabolized, but extensively excreted via bile)
*Excretion: Bile (70-75%), Urine (20-30%)
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis. Contains N-methylthiotetrazole (MTT) side chain.

==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||'''S'''
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||R
|-
| ||[[Enterococcus faecium]]||R
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||R
|-
| Gram Negatives||[[N. gonorrhoeae]]||'''S'''
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||I
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||'''S'''
|-
| ||Serratia marcescens||'''S'''
|-
| ||[[Salmonella]] sp||'''S'''
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||'''S'''
|-
| ||[[Providencia sp.]]||'''S'''
|-
| ||[[Morganella sp.]]||'''S'''
|-
| ||[[Citrobacter freundii]]||I
|-
| ||[[Citrobacter diversus]]||'''S'''
|-
| ||[[Citrobacter sp.]]||I
|-
| ||[[Aeromonas sp]]||'''S'''
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||'''S'''
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||'''S'''
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||'''S'''
|-
| ||[[Vibrio vulnificus]]||'''S'''
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||R
|-
| ||[[Mycobacterium avium]]||R
|-
| Anaerobes||[[Actinomyces]]||'''S'''
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||I
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}

===Key===
{{Template:Antibacterial Spectra Key}}

==See Also==
*[[Antibiotics (Main)]]

==References==
<references/>

[[Category:Pharmacology]] [[Category:ID]]