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Cefoperazone Side Effects

Medically reviewed by Last updated on Mar 8, 2024.

Applies to cefoperazone: injectable powder for injection.


Hypersensitivity reactions, often manifested as skin rashes, are common with cefoperazone 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 side effects have included nausea, vomiting and diarrhea, the latter being the most frequent. Clostridium difficile has been documented in some patients receiving cefoperazone.[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 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 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 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 side effects have included pain after intramuscular injection and phlebitis after intravenous infusion.[Ref]


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]


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Further information

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Some side effects may not be reported. You may report them to the FDA.