Cefoperazone: veterinary dose and monograph

At a glance

Drug class

Antibiotic

Also known as

Mammicef, Mamiprotec, Gardplus

Species with doses

Cattle

General dose range

2.5–10 mg/kg Intramammary q24h — check the species tables for the indication

Routes

Intramammary, IM

Last reviewed

1 October 2026

Indications

• Bovine clinical mastitis (single-dose intramammary)
• Bovine acute pneumonia / metritis (parenteral, with sulbactam)
• Soft tissue infections (off-label small animal use elsewhere)

Cefoperazone dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Cattle

• Clinical mastitis (Mammicef / Mamiprotec): Label-sourced — 250 mg (one 10 mL syringe) per affected quarter as a single infusion after milking. Cefoperazone has no monograph in Papich 5e or Plumb’s; follow the product label for meat and milk withdrawals.
• Septicaemic mastitis / metritis (parenteral cefoperazone + sulbactam): Dose per Indian product literature for the parenteral cefoperazone + sulbactam combination; no cefoperazone monograph exists in Papich 5e or Plumb’s. Withdrawal is not established — treat as extra-label and consult the product label. Product literature dose: 5–10 mg/kg IM q12–24h for 3–5 days.

Goats

• No reference dose for this species: The previous half-syringe goat regimen had no source; cefoperazone is not in Papich 5e or Plumb’s and the intramammary products are labelled for cattle only.

Buffalo

No buffalo-specific doses are on file, so buffalo are dosed as cattle.

• Clinical mastitis (Mammicef / Mamiprotec): Label-sourced — 250 mg (one 10 mL syringe) per affected quarter as a single infusion after milking. Cefoperazone has no monograph in Papich 5e or Plumb’s; follow the product label for meat and milk withdrawals.
• Septicaemic mastitis / metritis (parenteral cefoperazone + sulbactam): Dose per Indian product literature for the parenteral cefoperazone + sulbactam combination; no cefoperazone monograph exists in Papich 5e or Plumb’s. Withdrawal is not established — treat as extra-label and consult the product label. Product literature dose: 5–10 mg/kg IM q12–24h for 3–5 days.

Contraindications

Cephalosporin hypersensitivity. Vitamin K depletion risk on prolonged use (NMTT side chain). Renal failure — reduce dose.

Species-specific warnings

Cattle: Intramammary preparations (Mammicef, Mamiprotec) are standard for clinical mastitis. Strict milk withdrawal per product label.

Dogs: Useful for pyometra, complicated UTI, Pseudomonas infection. Combination with sulbactam (Gardplus) for ESBL coverage.

Horses: Not commonly used — risk of antibiotic-associated colitis as with all broad-spectrum cephs.

Rabbits: Avoid — fatal clostridial enterotoxaemia.

Adverse effects

• Mild local intramammary inflammation
• Hypersensitivity (rare)
• Hypoprothrombinaemia on prolonged systemic use

Drug interactions

• Aminoglycosides: synergistic against Pseudomonas — but do NOT mix in syringe
• NSAIDs / loop diuretics: additive nephrotoxicity in dehydrated patients
• Penicillins: cross-reactivity for hypersensitivity (~10%)
• Warfarin: cefoperazone can prolong PT via vitamin K antagonism — monitor INR
• Alcohol-containing IV solutions: DISULFIRAM-like reaction (NTM side chain) — flushing, nausea
• Calcium-containing IV fluids: less restrictive than ceftriaxone but still avoid co-infusion

Pregnancy and lactation

Considered safe in pregnant cattle, bitches at therapeutic doses. Excreted in milk (intramammary preparation: strict withdrawal). FDA Category B (human extrapolation).

Monitoring

• Coagulation (PT) if used for >7 days — vitamin K antagonism risk
• Withdrawal periods (intramammary, lactating): per product — verify before reuse
• Renal function on prolonged courses
• Hypersensitivity signs
• GI signs — diarrhoea / dysbiosis
• Avoid alcohol-containing products (rare in vet but flag for staff handling)

Toxicity and overdose

Wide therapeutic margin. Acute toxicity rare. Coagulopathy / prolonged PT from vitamin K antagonism (NTM side chain — unique among cephs) — caution in patients with bleeding tendency or warfarin therapy. Disulfiram-like reaction if patient ingests alcohol-containing products. Injection-site pain. Hypersensitivity (rare). Diarrhoea / dysbiosis on prolonged courses.

Management: No specific antidote. Supportive: IV fluids. Coagulopathy: vitamin K1 5 mg/kg SC, fresh frozen plasma if bleeding. Anaphylaxis: standard protocol. Discontinue and monitor PT if coagulopathy develops.

Clinical pearls

• Bovine clinical mastitis (Mammicef, Mamiprotec): 250 mg per affected quarter — single dose / per label
• Bovine soft tissue / pneumonia with septicaemia (Gardplus, cefoperazone + sulbactam): IV/IM per label
• Pseudomonas coverage is BETTER than most 3rd-gen cephs — useful for resistant otitis externa, UTI
• Canine pyometra (extra-label): 25 mg/kg IV q8–12h — high biliary excretion targets reproductive tract
• Combination with sulbactam (Gardplus) extends spectrum against beta-lactamase producers including ESBL
• Vitamin K antagonism: monitor PT on courses >7 days; supplement vitamin K if needed
• NEVER mix with alcohol-containing IV products — disulfiram-like reaction

Mechanism of action

Third-generation cephalosporin (human-medicine origin). Binds penicillin-binding proteins (PBPs) — inhibits transpeptidase cross-linking of peptidoglycan. Bactericidal, time-dependent. Broad spectrum: Gram-positive cocci (incl. some beta-lactamase producers), wide Gram-negative coverage (E. coli, Klebsiella, Proteus, Enterobacter, Pasteurella, Pseudomonas — UNIQUE among 3rd-gen cephs for some Pseudomonas activity). Stable to many beta-lactamases (further enhanced by sulbactam combination — Gardplus). Excellent biliary excretion (advantage in cholangitis / pyometra).

Formulations and products

• Mammicef intramammary 250 mg/10 mL syringe (Intas)
• Mamiprotec intramammary 250 mg per syringe (Virbac)
• Gardplus parenteral vial — cefoperazone + sulbactam (Virbac; strength not stated in the catalogue — reconstitute per pack label)
• Mammicef (Intas (Neovet)) — 250 mg per 10 mL syringe, Intramammary syringe
• Mamiprotec (Virbac) — 250 mg per syringe, Intramammary syringe
• Gardplus (Virbac) — Cefoperazone + Sulbactam, Parenteral vial
• Mammitel (Intas (Neovet)) — Colistin 500 000 IU + Cloxacillin 200 mg / 10 g syringe, Intramammary syringe (mastitis combo)
• Ceftabrut-TAZO (Mankind Veticura) — Cefoperazone 3 g + Tazobactam 375 mg (3.375 g vial) or Cefoperazone 4 g + Tazobactam 500 mg (4.5 g vial), Vial — reconstitute and give IV or IM
• Surezone-SB 4.5 (Assure Biotech, Jagadhri (HR)) — Cefoperazone 3 g + Sulbactam 1.5 g, Dry powder vial

Storage

Powder vial: 15–25 °C, protect from light. Reconstituted: use within 24 h refrigerated. Intramammary syringes (Mammicef, Mamiprotec): 15–25 °C — do NOT freeze. Multidose vial: 28 days after broaching.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

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Frequently asked questions