A case report of rash induced by cefoperazone sodium and sulbactam sodium plus metronidazole sodium chloride combined with morphine hydrochloride

Ann Palliat Med. 2020 Nov;9(6):4377-4383. doi: 10.21037/apm-20-2192.

Abstract

We report a case of rashes in a patient undergoing cesarean section. She was administered cefoperazone and sulbactam sodium + metronidazole sodium chloride combined with morphine hydrochloride perioperatively, which caused a rash as an adverse side effect. The patient, 35 years old, underwent lower uterine segment cesarean section under combined spinal-epidural anesthesia. She received intravenous infusion of cefoperazone sodium and sulbactam sodium + metronidazole sodium chloride for anti-infection therapy before operation and morphine hydrochloride for analgesia at the end of the operation. The patient later experienced skin itching and had rashes on the waist, abdomen, and back. According to the patient's physical signs, the correlation with drug injection time, and the adverse side effects reported in the drug instructions and related literature, the adverse side effect may have been caused by cefoperazone sodium and sulbactam sodium, metronidazole sodium chloride, and morphine hydrochloride. The drugs were suspended, and the patient was given anti-allergic treatment. After that, the above symptoms subsided. Therefore, we suspect that cefoperazone sodium and sulbactam sodium, metronidazole sodium chloride, or morphine hydrochloride injection, or a combination of two or more of these drugs, caused the adverse side effect of skin rash in the patient. This study reports a case of adverse side effects of skin itching and rash after the use of cefoperazone sodium and sulbactam sodium, metronidazole sodium chloride, and morphine hydrochloride in a pregnant woman undergoing cesarean section. The occurrence of adverse side effects in special populations should attract clinicians' attention. When giving such drugs, medical personnel should take a full history the patient's allergy and closely monitor the occurrence of adverse side effects in the early stages of medication.

Keywords: Cefoperazone sodium and sulbactam sodium; case report; metronidazole sodium chloride; morphine hydrochloride; rash.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / adverse effects
  • Cefoperazone* / adverse effects
  • Cesarean Section
  • Chlorides
  • Drug Therapy, Combination
  • Exanthema* / drug therapy
  • Female
  • Humans
  • Metronidazole / adverse effects
  • Morphine Derivatives
  • Pregnancy
  • Sodium Chloride
  • Sulbactam / adverse effects

Substances

  • Anti-Bacterial Agents
  • Chlorides
  • Morphine Derivatives
  • Metronidazole
  • Sodium Chloride
  • Cefoperazone
  • Sulbactam