CEFOBID IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for CEFOBID IN PLASTIC CONTAINER (CEFOBID IN PLASTIC CONTAINER).
Cefoperazone, a third-generation cephalosporin, inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), inhibiting peptidoglycan cross-linking, and activating autolytic enzymes.
| Metabolism | Primarily excreted unchanged in bile (70-80%) and urine (20-30%); minimal hepatic metabolism; no significant cytochrome P450 involvement. |
| Excretion | Renal: 65-85% unchanged; biliary: 10-20% (fecal elimination); total renal clearance approximates glomerular filtration rate. |
| Half-life | 2.2 hours (normal renal function); prolonged to 4-5 hours in elderly or hepatic impairment; in severe renal failure (CrCl <10 mL/min), may extend up to 8 hours. |
| Protein binding | 85-90% bound to albumin. |
| Volume of Distribution | 0.14-0.28 L/kg; indicates distribution primarily into extracellular fluid; increased in neonates and patients with hypoalbuminemia. |
| Bioavailability | Intramuscular: approximately 100% (well absorbed). |
| Onset of Action | Intravenous: immediate (within minutes); intramuscular: peak serum concentrations at 1-2 hours. |
| Duration of Action | 8-12 hours (based on dosing interval of q12h); clinical effect persists for the dosing interval due to time-dependent killing. |
2 g IV every 8-12 hours; usual total daily dose 4-6 g, severe infections up to 12 g daily divided q8h.
| Dosage form | INJECTABLE |
| Renal impairment | CrCl 30-50 mL/min: 1-2 g q12h; CrCl 10-29 mL/min: 1-2 g q24h; CrCl <10 mL/min: 0.5-1 g q24h; hemodialysis: 1-2 g post-dialysis. |
| Liver impairment | Child-Pugh A: no adjustment; Child-Pugh B: reduce dose by 50%; Child-Pugh C: reduce dose by 75%. |
| Pediatric use | Neonates: 100-150 mg/kg/day IV divided q12h; Infants/Children: 100-150 mg/kg/day IV divided q8h; maximum 12 g/day. |
| Geriatric use | Base on renal function; same as adult renal adjustment. Reduce initial dose if CrCl <30 mL/min. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for CEFOBID IN PLASTIC CONTAINER (CEFOBID IN PLASTIC CONTAINER).
| Breastfeeding | Cefoperazone is excreted in human milk in low concentrations (M/P ratio not established). Caution should be exercised when administered to a nursing woman. |
| Teratogenic Risk | FDA Pregnancy Category B. Animal studies have not demonstrated fetal risk, but no adequate human studies in pregnant women. Use only if clearly needed. |
| Fetal Monitoring |
■ FDA Black Box Warning
No U.S. FDA black box warning exists for cefoperazone.
| Serious Effects |
History of severe hypersensitivity to cephalosporins or other beta-lactam antibiotics.
| Precautions | Hypersensitivity reactions including anaphylaxis; pseudomembranous colitis due to Clostridioides difficile; bleeding risk due to hypoprothrombinemia (especially in elderly, malnourished, or renal impairment); superinfection; risk of nephrotoxicity with aminoglycosides. |
| Food/Dietary | No specific food interactions. However, avoid alcohol and any products containing alcohol (e.g., cough syrups, mouthwash) during treatment and for 72 hours after last dose due to risk of disulfiram-like reaction. |
Loading safety data…
| Monitor maternal renal function, hepatic function, and complete blood counts during prolonged therapy. Fetal monitoring as clinically indicated. |
| Fertility Effects | No known adverse effects on fertility in animal studies. |
| Clinical Pearls |
| CEFOBID (cefoperazone) is a third-generation cephalosporin with extended gram-negative coverage, including Pseudomonas aeruginosa. It is dosed twice daily due to a long half-life. Monitor for disulfiram-like reaction if alcohol consumed within 72 hours. Administer IV infusion over 15-30 minutes. Dose adjustment required in hepatic impairment but not in renal impairment alone. |
| Patient Advice | Avoid alcohol and alcohol-containing products during treatment and for 3 days after stopping. · Report any signs of allergic reaction, including rash, itching, or difficulty breathing. · Complete the full course of therapy even if you feel better. · May cause diarrhea, nausea, or headache; contact doctor if severe or persistent. · This medication is given intravenously; do not mix with other drugs in the same line without consulting a pharmacist. |