Cefoperazone–Sulbactam-induced anaphylaxis

Abstract Anaphylaxis to cephalosporins is relatively uncommon but can rapidly become life-threatening. This is a case of an 18-year-old male who developed severe anaphylaxis following intravenous administration of cefoperazone–sulbactam despite having tolerated several prior exposures without adverse effects. Within 15 min of injecting the drug, he developed acute breathlessness, hypotension, and generalized urticaria, progressing to respiratory failure that required urgent intubation and mechanical ventilation. Intensive care management with adrenaline, corticosteroids, and supportive therapy led to gradual recovery, and the patient was successfully discharged. This case underscores the unpredictable nature of drug hypersensitivity, where prior tolerance does not guarantee future safety. It also highlights the critical importance of preparedness for anaphylaxis even with commonly used antibiotics.