Cefper Mechanism of Action

PHARMACODYNAMICS: Cefoperazone, a third generation cephalosporin, which acts against sensitive organisms during the active multiplication by inhibiting biosynthesis of cell wall mucopeptide. Sulbactam does not possess any useful antibacterial activity, except against Neisseriaceae and Acinetobacter. However, biochemical studies have shown its action as an irreversible inhibitor of most important beta-lactamases produced by beta-lactam antibiotic-resistant organisms. The combination of Cefoperazone and Sulbactam demonstrates, synergistic activity in a variety of organisms most markedly the following: Haemophilus influenzae, Bacteroides species, Staphylococcus species, Acinetobacter calcoaceticus, Enterobacter aerogenes, E. coli, Proteus mirabilis, Klebsiella pneumoniae, Morganella morganii, Citrobacter freundii, Enterobacter cloacae, Citrobacter diversus.
Sulbactam/Cefoperazone is active in vitro against a wide variety of clinically significant organisms: Gram-Positive Organisms: Staphylococcus aureus, penicillinase and non-penicillinase-producing strains. Streptococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyrogenes, Streptococcus agalactiae and most other strains of Beta-hemolytic streptococci.
Gram-Negative Organisms: E. coli, Klebsiella species, Enterobacter species, Citrobacter species, Haemophilus influenzae, Proteus mirabilis, Proteus vulgaris, Marganella morganii, Providencia rettgeri (formerly Proteus morganii), Providencia species, Serratia species (including S. marcescens), Salmonella and Shigella species, Pseudomonas aeroginosa and some other Pseudomonas species, Acinetobacter calcoaceticus, Neisseria gonorrhoeae and Neisseria meningitidis.
Anaerobic Organisms: Gram-negative bacilli (including Bacteroides fragilis, other Bacteroides species and Fusobacterium species).
Gram-positive and Gram-negative cocci (including Peptococcus and Peptostrepto coccus).
Gram-positive bacilli (including Clostridium and Eubacterium).
PHARMACOKINETICS: Approximately 84% of the Sulbactam dose and 25% of the Cefoperazone dose administered with Sulbactam/Cefoperazone is excreted by the kidney. Most of the remaining dose of Cefoperazone is excreted in the bile. After Sulbactam/Cefoperazone administration the mean half-life for Sulbactam is about 1 hour while that for Cefoperazone is 1.7 hours. Sulbactam and Cefoperazone exhibited longer half-life in elderly individuals with renal insufficiency and compromised hepatic function.
Both Sulbactam and Cefoperazone distribute well into a variety of tissues and fluids including bile, gall bladder, skin, ovary, uterus, and others.