Cefpodoxime +Ofloxacin in RTI : Cefpodoxime +Ofloxacin in RTI Medical
Infections : Presentation Title
Date Company Confidential© 200X Abbott Major cause of morbidity and mortality in the world.
Respiratory tract infections
Skin &Soft tissue infections
Post- op wound infections
Urinary tract infections Infections
Infections : Presentation Title
Date Company Confidential© 200X Abbott Infections Caused by micro organisms (virus, bacteria, fungi or protozoa).
Can infect any part of the body.
Bacterial infections are very common and requires prompt treatment with antibiotics.
Most common Infections : Presentation Title
Date Company Confidential© 200X Abbott Most common Infections Respiratory Tract infections are the most common form of infectious diseases.
According to a WHO report LRTI (Lower Respiratory Tract Infections) are the leading cause of deaths globally.
Respiratory Tract : Presentation Title
Date Company Confidential© 200X Abbott Respiratory Tract
Respiratory Tract Infections and Organisms : Presentation Title
Date Company Confidential© 200X Abbott Respiratory Tract Infections and Organisms Organisms causing RTI
Gram Positive bacteria- e.g. Streptococcus, Staphylococcus
Gram negative Bacteria- e.g. H. influenzae, Klebsiella,
Atypical Bacteria- Mycoplasma, Chlamydia, etc
Clinical Presentation of RTI : Presentation Title
Date Company Confidential© 200X Abbott Clinical Presentation of RTI The most common signs and symptoms of RTI are-
Cough- Most commonly found in lower respiratory tract infections
Fever
Chest Congestion-most commonly found in the lower respiratory tract infections.
Headache
Malaise
Nasal Congestion
Earache- Most common in Otitis Media
Nausea/Vomiting
Wheezing
Conditions affecting the host immunity and treatment : Presentation Title
Date Company Confidential© 200X Abbott Conditions affecting the host immunity and treatment Previous exposure to antibiotics but not responding
Patients with asthma
AECB in smokers
Alcoholic patients
Past history of TB
Diabetic patients
Diagnosis of RTI : Presentation Title
Date Company Confidential© 200X Abbott Diagnosis of RTI Diagnosis of RTI is most commonly done on clinical presentation by the patient and a complete history.
Further investigations when required include
Chest x-ray
Complete Blood count
Sputum Culture
Throat culture
Treatment of RTI : Presentation Title
Date Company Confidential© 200X Abbott Treatment of RTI Apart from symptomatic treatment for
Fever (antipyretics),
Headache (analgesics),
Cough (cough suppressants) and
Nasal decongestion (nasal decongestants);
Antibiotics should be started immediately.
Antibiotics used in RTI : Presentation Title
Date Company Confidential© 200X Abbott Antibiotics used in RTI Aminopenicillins: Amoxycillin, ampicillin
Cephalosporins: Cefadroxyl, cefuroxime, Cefpodoxime, Cefixime
Macrolides: erythromycin, Azithromycin
Fluoroquinolones: Ciprofloxacin, Ofloxacin, Levofloxacin
Current Treatment Options and their limitations : Presentation Title
Date Company Confidential© 200X Abbott Current Treatment Options and their limitations Penicillins- Penicillins like Amoxicillin and ampicillin are frequently used in the treatment of RTI.
They have a good coverage against Gram positive organisms and anaerobes, less Gram negative coverage.
Dosage –
Amoxicillin 250mg -500 mg for 5-7 days.
Limitations-
Inactive against atypicals and not adequate Gram negative coverage.
Current Treatment Options and their limitations : Presentation Title
Date Company Confidential© 200X Abbott Current Treatment Options and their limitations Fluoroquinolones- most commonly used for RTI are Ofloxacin, Levofloxacin, Gatifloxacin, etc
The spectrum of activity of fluoroquinolones include Gram negative, Gram positive and atypicals
Dosage-
Levofloxacin in a dose of 500 mg once daily for 5 days
Ofloxacin in the dose of 200-400 mg BD for 5-7 days.
Limitations-
Spectrum- ofloxacin, ciprofloxacin inactive against Streptococci
Current Treatment Options and their limitations : Presentation Title
Date Company Confidential© 200X Abbott Current Treatment Options and their limitations Macrolides- Azithromycin, Erythromycin and Clarithromycin
Coverage- Macrolides have a very good coverage not only against Gram positive and gram negative bacteria, but also against Atypical bacteria.
Dosage-
Azithromycin is usually given in a dosage of 500 mg OD for 3 days.
Limitations-
Less active against Gram positives
Gastric irritation
Current Treatment Options and their limitations : Presentation Title
Date Company Confidential© 200X Abbott Current Treatment Options and their limitations Cephalosporins- Cephalosporins are well accepted in the treatment of Respiratory Tract Infections.
They are active against Gram positive and Gram negative organisms causing RTI.
Cefpodoxime is used in a dose of 200 mg BD for 5-7 days.
Cefixime is given in a dose of 200 mg BD for 5-7 days.
Limitations – Cephalosporins are not active against atypical organisms which form a major part of RTI.
Atypical Organisms : Presentation Title
Date Company Confidential© 200X Abbott Atypical Organisms Atypical bacteria, like Mycoplasma pneumoniae, Chlamydophila pneumonia and Legionella pneumophila play significant role in respiratory tract infections
Account for 40% of all cases of community acquired pneumonia (CAP).
These organisms commonly occur as co-pathogens in mixed infections
Mortality rates as high as 25%.
The atypical respiratory pathogens, C. pneumoniae, M. pneumoniae and Legionella spp., have an important and broad role in acute infections of the lower and upper respiratory tract (to a lesser extent).
Infection with M. pneumoniae and C. pneumoniae has been linked to a worsening of asthma.
Solution : Presentation Title
Date Company Confidential© 200X Abbott Solution Due to the increasing incidence of resistance of the pathogens causing RTI to the currently used therapies, there is a need of
finding new drugs or
using combination of drugs
Combination of Drugs : Presentation Title
Date Company Confidential© 200X Abbott Combination of Drugs The advantages of Combination of Drugs-
Widen the spectrum of activity
Increased patient compliance
Added synergy of the 2 drugs
Faster cure
Increase success rate
Combination of Drugs in RTI : Presentation Title
Date Company Confidential© 200X Abbott Combination of Drugs in RTI Since Respiratory Tract infections are most commonly caused by Gram positive, Gram negative and Atypical organisms, we need a drug with a wide spectrum covering all the pathogens.
Also, the drug should be able to fight against resistance by these organisms.
Now a days physicians are prescribing concomitant drugs for better and faster cure.
Cefpodoxime and Ofloxacin are the most concomitantly prescribed drugs in RTI.
Ofloxacin : Presentation Title
Date Company Confidential© 200X Abbott Ofloxacin 1st generation fluoroquinolone.
Bactericidal- acts on the DNA gyrase and topoisomerase IV
Broad spectrum
Gram negative, Gram positive (only Staphylococci) and the Atypical organisms are sensitive to Ofloxacin.
The side effect profile of ofloxacin is better than other fluoroquinolones.
Ofloxacin is widely distributed to body tissues.
Between 65% and 80% of an administered oral dose of ofloxacin is excreted unchanged via the kidneys within 48 hours of dosing.
The usual dosing of ofloxacin is 200-400 mg BD for 5-7 days.
Cefpodoxime : Presentation Title
Date Company Confidential© 200X Abbott Cefpodoxime 3rd generation cephalosporin.
Bactericidal- acts on the organism by inhibiting bacterial cell wall synthesis.
Very active against Gram positive and Gram negative organisms
Has excellent tissue penetration and good half life.
The usual dosing in RTI – 200 mg BD for 5-7 days depending upon the severity of infection.
Bacterial Toxins and the combination : Presentation Title
Date Company Confidential© 200X Abbott Bacterial Toxins and the combination Whenever there is a bacterial infection, there is release of toxins by the bacteria which produces tissue damage.
This results into symptoms like fever, cough, etc.
The combination cefpodoxime and ofloxacin reduces the bacterial toxins.
There is a potential to reduce the fever at a faster rate and relieve the patient from the symptoms.
Cefpodoxime and Ofloxacin act on the CRITICAL Bacterial growth phases : Presentation Title
Date Company Confidential© 200X Abbott Cefpodoxime and Ofloxacin act on the CRITICAL Bacterial growth phases Incubation period immediately after the infection
No symptoms in the patient Rapid multiplication phase
Symptoms arise such as fever
Cefpodoxime + Ofloxacin will give RAPID and potent killing power Toxins build up and fever increases
Toxins are reduced by ofloxacin Reduced tissue damage Decreasing bacterial numbers and eradication of infection
Potent killing by the combination of cefpodoxime and ofloxacin
Cefpodoxime + Ofloxacin : Presentation Title
Date Company Confidential© 200X Abbott Cefpodoxime + Ofloxacin The combination is also effective in the following patients-
Patients with High fever (>100*F) due to the infection
Patients with other respiratory illness like
Asthma
AECB
Smokers
Past history of TB
Cefpodoxime+Ofloxacin : Presentation Title
Date Company Confidential© 200X Abbott Cefpodoxime+Ofloxacin Composition-
Each tablet of Finecef-O contains Cefpodoxime 200 mg + Ofloxacin 200 mg
Indication-
Moderate to severe respiratory tract infections in adults
Dosage-
Cefpodoxime 200 mg +Ofloxacin 200 mg tablet to be given twice daily after meals for 5-7 days depending upon the severity of the condition.
Side effects and Drug Interactions : Presentation Title
Date Company Confidential© 200X Abbott Side effects and Drug Interactions Side effects-
Nausea, vomiting, GI disturbances.
Drug Interactions-
Antacids, Theophylline, warfarin
Cefpodoxime+Ofloxacin comparison with commonly used molecules : Presentation Title
Date Company Confidential© 200X Abbott Cefpodoxime+Ofloxacin comparison with commonly used molecules
USPs of the combination of Cefpodoxime+ Ofloxacin : Presentation Title
Date Company Confidential© 200X Abbott USPs of the combination of Cefpodoxime+ Ofloxacin Wider spectrum of activity against RTI pathogens.
Faster cure
Better success rate
Less chances of relapse
Double attack of organisms since the mode of action is different, hence assuring complete cure
Synergistic effect of the drugs
Better patient compliance- the patient has to take only one tablet as against 2 separately.
Summary : Presentation Title
Date Company Confidential© 200X Abbott Summary The combination would be useful in cases where the doctor has to use both these drugs and in patients who have compromised immunity and co existing illnesses.
The use of this combination would improve patient compliance, producing better cure rates and would have a potential in producing faster clinical cures.
The combination would have good potential and would be a useful addition for the physician in the treatment of respiratory tract infections.
Slide 30 : Presentation Title
Date Company Confidential© 200X Abbott Thank You