What is the use and dosage of Cefeperazone (a third-generation cephalosporin antibiotic) in treating bacterial infections, particularly those caused by Gram-negative bacteria?

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Last updated: June 2, 2025View editorial policy

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From the Research

Cefeperazone is a third-generation cephalosporin antibiotic that should be used to treat serious infections caused by Gram-negative bacteria, with a typical adult dosage of 2 to 4 grams per day, divided into two equal doses administered every 12 hours, as supported by 1.

Key Points

  • Cefeperazone has a broad spectrum of bactericidal activity against most aerobic Gram-positive bacteria, except enterococci, most aerobic Gram-negative bacteria, including a majority of Pseudomonas aeruginosa strains, and some anaerobic bacteria 1.
  • The long serum half-life of cefeperazone, approximately two hours, permits a twelve-hourly dosing schedule, with no dosage modification required in patients with renal insufficiency, and only minor modification needed in patients with hepatic insufficiency or biliary obstruction 1.
  • Clinical trials have established cefeperazone's efficacy in lower respiratory tract infections, urinary tract infections, and other bacterial infections, with adverse reactions being infrequent and few serious reactions identified 1.
  • Cefeperazone is particularly effective against Pseudomonas aeruginosa and other resistant Gram-negative bacteria due to its enhanced ability to penetrate the bacterial cell wall and resist beta-lactamase enzymes.

Dosage and Administration

  • The typical adult dosage of cefeperazone ranges from 2 to 4 grams per day, divided into two equal doses administered every 12 hours.
  • For severe infections, the dosage may be increased up to 6-12 grams daily.
  • Cefeperazone is administered intravenously or intramuscularly and should be reconstituted according to manufacturer guidelines.

Monitoring and Precautions

  • Patients should be monitored for side effects including gastrointestinal disturbances, allergic reactions, and potential vitamin K deficiency which may affect blood clotting.
  • Alcohol should be avoided during treatment and for 72 hours afterward due to potential disulfiram-like reactions. However, it's worth noting that more recent studies, such as 2, have investigated the efficacy of other antibiotics, like cefiderocol, against Gram-negative bacteria, including carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa, but cefeperazone remains a viable option for treating serious infections caused by Gram-negative bacteria, as supported by the available evidence 1.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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