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Cefobid Side Effects

Generic name: cefoperazone

Medically reviewed by Drugs.com. Last updated on Dec 24, 2023.

Note: This document contains side effect information about cefoperazone. Some dosage forms listed on this page may not apply to the brand name Cefobid.

Applies to cefoperazone: injectable powder for injection.

Hypersensitivity

Hypersensitivity reactions, often manifested as skin rashes, are common with cefoperazone (the active ingredient contained in Cefobid) and may require drug discontinuation. Drug fever and changes in Coombs' tests have also been reported. Allergic cross-reactivity may occur in patients allergic to penicillin. Cephalosporin class antibiotics have been associated with anaphylaxis, Stevens-Johnson syndrome, erythema multiforme, and toxic epidermal necrolysis.[Ref]

A case of occupational contact dermatitis due to cephalosporin allergy has been reported in a nurse who prepared cephalosporin solutions for administration to patients. The dermatitis resolved after the nurse stopped preparing the solutions.[Ref]

Gastrointestinal

Gastrointestinal side effects have included nausea, vomiting and diarrhea, the latter being the most frequent. Clostridium difficile has been documented in some patients receiving cefoperazone (the active ingredient contained in Cefobid) [Ref]

The frequent occurrence of diarrhea is thought to be due to the disturbance of intestinal flora from high biliary concentrations of cefoperazone. In a study evaluating the intestinal side effects of cefoperazone, Clostridium difficile was found in the stool of several patients with diarrhea. In at least three of these cases no treatment was necessary and symptoms resolved.[Ref]

Hepatic

Hepatic side effects have included alterations in serum transaminases and alkaline phosphatase in 5% to 10% of patients, but drug discontinuation was usually not necessary. These changes are usually mild and transient and return to normal following completion of therapy. Cephalosporins as a class have been associated with hepatic dysfunction including cholestasis.[Ref]

Hematologic

Hematologic abnormalities have included eosinophilia, neutropenia, decreases in hemoglobin and hematocrit, thrombocytopenia, hypoprothrombinemia, and leukopenia. In most cases, these alterations do not require drug discontinuation or dosage reduction. Cephalosporins as a class have been associated with aplastic anemia, hemolytic anemia, prolonged prothrombin time, hemorrhage, neutropenia, pancytopenia, and agranulocytosis.[Ref]

The effect of cefoperazone on hemostasis has been evaluated in at least one study and reported in several cases. In most of these cases, the patient had normal coagulation parameters, prothrombin time and partial thromboplastin time prior to starting cefoperazone therapy. Within several days to weeks, prolongation of prothrombin time and partial thromboplastin time developed. Bleeding occurred in some cases. Administration of vitamin K or fresh frozen plasma corrected the changes in most of these patients. Cefoperazone was continued in several patients.[Ref]

Renal

Renal side effects have included transient elevations of BUN and creatinine, and acute interstitial nephritis with renal failure. Cephalosporins as a class have been associated with renal dysfunction and toxic nephropathy.[Ref]

Local

Local side effects have included pain after intramuscular injection and phlebitis after intravenous infusion.[Ref]

Dermatologic

Dermatologic side effects associated with cephalosporin class antibiotics have included rash, Stevens-Johnson syndrome, erythema multiforme, and toxic epidermal necrolysis.[Ref]

Nervous system

Nervous system side effects associated with some cephalosporins have included seizures in renally impaired patients.[Ref]

References

1. Product Information. Cefobid (cefoperazone). Roerig Division. 2002;PROD.

2. Filipe P, Almeida RSLS, Rodrigo FG. Occupational allergic contact dermatitis from cephalosporins. Contact Dermatitis. 1996;34:226.

3. Romano A, Mayorga C, Torres MJ, Artesani MC, Suau R, Sanchez F, Perez E, Venuti A, Blanca M. Immediate allergic reactions to cephalosporins: Cross-reactivity and selective responses. J Allerg Clin Immunol. 2000;106:1177-83.

4. Mashimo K, Kunii O. Clinical trials with cefoperazone in the field of internal medicine in Japan. Clin Ther. 1980;3:159-72.

5. Shibata K. Clinical trials with cefoperazone in the field of surgery in Japan. Clin Ther. 1980;3:173-89.

6. Norrby R, Alestig K. Gastrointestinal reactions to cefoperazone. Lancet. 1981;2:1417.

7. Carlberg H, Alestig K, Nord CE, Trollfors B. Intestinal side effects of cefoperazone. J Antimicrob Chemother. 1982;10:483-7.

8. Gordon AJ, Phyfferoen M. Cefoperazone sodium in the treatment of serious bacterial infections in 2,100 adults and children: multicentered trials in Europe, Latin America, and Australasia. Rev Infect Dis. 1983;5:s188-99.

9. Gardner WG. Multicentered clinical evaluation of cefoperazone for the treatment of lower respiratory tract infections. Rev Infect Dis. 1983;5:s137-44.

10. Warren JW, Miller EH, Fitzpatrick B, et al. A randomized, controlled trial of cefoperazone vs cefamandole-tobramycin in the treatment of putative, severe infections with gram-negative bacilli. Rev Infect Dis. 1983;5:s173-80.

11. Bolivar R, Fainstein V, Elting L, Bodey GP. Cefoperazone for the treatment of infections in patients with cancer. Rev Infect Dis. 1983;5:s181-7.

12. Cohen MS, Washton HE, Barranco SF. Multicenter clinical trial of cefoperazone sodium in the United States. Am J Med. 1984;77:35-41.

13. Saito A, Ueda Y. Multicenter clinical trials of cefoperazone in Japan. Clin Ther. 1984;7:49-59.

14. Rolston KV, Jones PG, Fainstein V, et al. Single agent therapy for infections in cancer patients: a prospective randomized trial comparing three extended-spectrum cephalosporins. Eur J Clin Microbiol Infect Dis. 1991;10:139-45.

15. Woods CJ, Ellis-Pegler RB. Cefoperazone in lower respiratory tract infections. Drugs. 1981;22:96-9.

16. Cristiano P. Hypoprothrombinemia associated with cefoperazone treatment. Drug Intell Clin Pharm. 1984;18:314-6.

17. Meisel S. Hypoprothrombinemia due to cefoperazone. Drug Intell Clin Pharm. 1984;18:316.

18. Parker SW, Baxter J, Beam TR. Cefoperazone-induced coagulopathy. Lancet. 1984;1:1016.

19. Andrassy K, Koderisch J, Fritz S, et al. Alteration of hemostasis associated with cefoperazone treatment. Infection. 1986;14:27-31.

20. Shenkenberg TD, Mackowiak PA, Smith JW. Coagulopathy and hemorrhage associated with cefoperazone therapy in a patient with renal failure. South Med J. 1985;78:488-9.

21. Freedy HR, Cetnarowski AB, Lumish RM, Schafer FJ. Cefoperazone-induced coagulopathy. Drug Intell Clin Pharm. 1986;20:281-3.

22. Osborne JC. Hypoprothrombinemia and bleeding due to cefoperazone. Ann Intern Med. 1985;102:721-2.

23. Trollfors B, Ahlmen J, Alestig K. Renal function during cefoperazone treatment. J Antimicrob Chemother. 1982;9:485-7.

24. Torun D, Sezer S, Kayaselcuk F, Zumrutdal A, Ozdemir FN, Haberal M. Acute Interstitial Nephritis Due to Cefoperazone (September). Ann Pharmacother. 2004.

Further information

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