There may be a positive response to the Coombs test although haemolytic anemia rarely occurs. Neutropenia and thrombocytopenia have occasionally been reported. Agranulocytosis has been associated rarely with some cephalosporins. Acute renal tubular necrosis has followed excessive dosage and has also been associated with its use in older patients or those with pre-existing renal impairment, or with the concomitant administration of nephrotoxic drugs such as aminoglycoside antibiotics. Acute interstitial nephritis is also a possibility as a manifestation of hypersensitivity. Transient increases in liver enzyme values have been reported. Hepatitis and cholestatic jaundice have occurred rarely with some cephalosporins. Convulsions and other signs of CNS toxicity have been associated with high doses, especially in patients with renal failure. Gastrointestinal adverse effects such as nausea, vomiting and diarrhea have been reported rarely. Prolonged use may result in overgrowth of non-susceptible organisms and, as with other broad-spectrum antibiotics, pseudomembranous colitis may develop.
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