Cefper Special Precautions

General: Vitamin K deficiency has occurred in a few patients treated with Cefoperazone. Those at risk include patients with poor diet, malabsorption states (e.g. cystic fibrosis), patients on prolonged intravenous alimentation regimens and patients receiving anticoagulant. The prothrombin time should be monitored and exogenous vitamin K should be administered. Prolonged using may cause overgrowth of non-susceptible organisms. It is advisable to check periodically for organ system dysfunction during extended therapy; this includes renal, hepatic, and hematopoietic systems. This is particularly important in neonates, especially when premature, and other infants.
Use in hepatic dysfunction: Cefoperazone is extensively excreted in bile. Dosage adjustment may be necessary in cases of severe biliary obstruction, severe hepatic disease or in cases of renal dysfunction coexistent with either of those conditions. In patients with hepatic dysfunction and concomitant renal impairment, dosage should not exceed 2 g of Cefoperazone activity/day, Cefoperazone serum concentrations should be monitored and dosage adjustment as necessary.
Use in renal dysfunction: Patients with creatinine clearances between 15 - 30 ml/min the maximum dose of Sulbactam should not exceed 1 g every 12 hours, while patients with creatinine clearances less than 15 ml/min the maximum dose of Sulbactam should not exceed 500 mg every 12 hours.
In severe case, the additional dose of Cefoperazone alone may be given. Patients with hemodialysis, half-life of serum Cefoperazone is reduced slightly during hemodialysis. Thus, dosing should be scheduled after dialysis period.
Use in pregnancy: No adequate and well-controlled studies in pregnant women. This drugs should be used during pregnancy only if clearly needed.
Use in lactation: Only small quantities of CEFPER are excreted in human milk. Caution should be exercised when the drug was administered in nursing mother.
Use in children: It has not been extensively studied in premature infants or neonates. Therefore, the potential benefit and possible risk must be considered before starting this medication. Cefoperazone does not replace bilirubin from plasma protein binding sites.