Cefoperazone indications and usage
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Abdurahman Khalil, M.D. [2]
CEFOBID is indicated for the treatment of the following infections when caused by susceptible organisms:
Respiratory Tract Infections caused by S. pneumoniae, H. influenzae, S. aureus (penicillinase and non-penicillinase producing strains), S. pyogenes1(Group A beta-hemolytic streptococci), P. aeruginosa,Klebsiella pneumoniae, E. coli, Proteus mirabilis, and Enterobacter species.
Peritonitis and Other Intra-abdominal Infections caused by E. coli, P. aeruginosa,1 and anaerobic gram-negative bacilli (including Bacteroides fragilis).
Bacterial Septicemia caused by S. pneumoniae, S. agalactiae,1 S. aureus,Pseudomonas aeruginosa,1 E. coli, Klebsiella spp.,1Klebsiella pneumoniae,1Proteus species1 (indole-positive and indole-negative), Clostridium spp.1 and anaerobic gram-positive cocci.1
Infections of the Skin and Skin Structures caused by S. aureus (penicillinase and non-penicillinase producing strains), S. pyogenes,1 and P. aeruginosa.
Pelvic Inflammatory Disease, Endometritis, and Other Infections of the Female Genital Tract caused by N. gonorrhoeae, S. epidermidis,1 S. agalactiae, E. coli, Clostridium spp.,1Bacteroides species (including Bacteroides fragilis), and anaerobic gram-positive cocci.
Urinary Tract Infections caused by Escherichia coli and Pseudomonas aeruginosa.
Enterococcal Infections: Although cefoperazone has been shown to be clinically effective in the treatment of infections caused by enterococci in cases of peritonitis and other intra-abdominal infections, infections of the skin and skin structures, pelvic inflammatory disease, endometritis and other infections of the female genital tract, and urinary tract infections,1 the majority of clinical isolates of enterococci tested are not susceptible to cefoperazone but fall just at or in the intermediate zone of susceptibility, and are moderately resistant to cefoperazone. However, in vitrosusceptibility testing may not correlate directly with in vivo results. Despite this, cefoperazone therapy has resulted in clinical cures of enterococcal infections, chiefly in polymicrobial infections. Cefoperazone should be used in enterococcal infections with care and at doses that achieve satisfactory serum levels of cefoperazone.
1 Efficacy of this organism in this organ system was studied in fewer than 10 infections.
Susceptibility Testing
Before instituting treatment with CEFOBID, appropriate specimens should be obtained for isolation of the causative organism and for determination of its susceptibility to the drug. Treatment may be started before results of susceptibility testing are available.
Combination Therapy
Synergy between CEFOBID and aminoglycosides has been demonstrated with many gram-negative bacilli. However, such enhanced activity of these combinations is not predictable. If such therapy is considered, in vitro susceptibility tests should be performed to determine the activity of the drugs in combination, and renal function should be monitored carefully. (See PRECAUTIONS, and DOSAGE AND ADMINISTRATION sections.)
References
http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=c6c2ef3b-2c53-4737-9f7d-2d7e040c6e87