Susceptible infections, especially those due to pseudomonas species.
Usual dose is 2 to 4g daily in 2 divided doses. In severe infections, up to 12g daily in 2 to 4 divided doses may be given
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Cefoperazone interferes with the synthesis of peptidoglycans, which are part of bacterial cell wall [bactericidal]. Sulbactam is a beta-lactamase inhibitor.
Potential for colonisation and superinfection with resistant organisms. Changes in bowel flora may be more marked than with cefotaxime because of the greater biliary excretion of cefoperazone; diarrhoea may occur more often. Cefoperazone contains an N-methylthiotetrazole side-chain, a structure associated with hypoprothrombinaemia. Hypoprothrombinaemia has been reported in patients treated with cefoperazone and has rarely been associated with bleeding episodes. Prothrombin time should be monitored in patients at risk of hypoprothrombinaemia and vitamin K used if necessary.
Diarrhoea and rarely antibiotic-associated colitis, nausea and vomiting, abdominal discomfort, headache; allergic reactions including rashes, pruritus, urticaria, serum sickness-like reactions with rashes, fever and arthralgia, and anaphylaxis; Stevens-Johnson syndrome, toxic epidermal necrolysis reported; disturbances in liver enzymes, transient hepatitis and cholestatic jaundice; other side-effects reported include eosinophilia and blood disorders (including thrombocytopenia, leucopenia, agranulocytosis, aplastic anaemia and haemolytic anaemia); reversible interstitial nephritis, hyperactivity, nervousness, sleep disturbances, hallucinations, confusion, hypertonia, and dizziness.