Oxidil - Fever without Focus FUO PUO.pptx

PUO

1. Fever without a Focus Recommendations from The Nelson Textbook of Pediatrics (21 st Edition)

2. Fever is a common reason for neonates and young infants to undergo medical evaluation in the hospital or ambulatory settings In neonates and infants, bacterial and viral infections can present with isolated fever or nonspecific symptoms, making diagnosis of serious illness challenging Fever without a Focus

3. Etiology & Epidemiology Serious bacterial infection (SBI) occurs in 7% to 13% of neonates and young infants with fever. In this group, the most common SBIs are: 1) Meningitis 2) Bacteremia 3) Urinary Tract Infections

4. Evaluation The evaluation of Fever without a Focus depend on the age of the child, for which three age groups are typically considered:

5. Treatment (as mentioned in Nelson) In neonates and young infants (0-3 months of age): Neonates and Infants hospitalized for evaluation for SBI should receive antimicrobial therapy. Commonly used regimens include: a third Generation Cephalosporin a third Generation Cephalosporin + Ampicillin However, For young infants >28 days , third generation cephalosporin (CEFTRIAXONE) can be a reasonable choice (Treatment duration and route of administration depend on the infection – Reference Nelson Textbook )

6. Treatment (as mentioned in Nelson) In Older Children: Blood tests, including CBC and blood culture, should be considered to evaluate for occult bacteremia in the unimmunized or ill appearing child One management strategy for these children is to administer a Parenteral Antibiotic (CEFTRIAXONE) if leukocytosis is present (WBC count > 15,000/ uL )

7. Oxidil ®

8. Oxidil ® - ( Ceftriaxone) A Brief Overview An FDA approved , third generation cephalosporin antibiotic has antimicrobial activity against both gram positive and gram negative organisms

9. Oxidil ® - ( Pharmacokinetics) Once Daily Dosing OXIDIL has an elimination half life of 8 Hours Longer half life of OXIDIL provides advantage of Once daily dosing

10. Oxidil ® - ( Pharmacokinetics) Less Frequent Drug Administration OXIDIL is 95% (Reversible) bound with plasma proteins High protein binding of OXIDIL acts as reservoir in blood and causes less frequent drug administration

11. Oxidil ® - ( Pharmacokinetics) Metabolism OXIDIL eliminates in unchanged form from the body This results in higher Ceftriaxone conc. in the bile & maintain sufficient bactericidal conc. in urine

12. Oxidil ® - ( Pharmacokinetics) Unique Dual Excretion OXIDIL has unique dual compensatory excretion mechanism In Impaired renal function, Hepatic excretion increases In Impaired Hepatic function, Renal excretion increases

13. Oxidil ® - ( Pharmacokinetics) Dosing Frequency OXIDIL is recommended with a dosing frequency of 24 Hrs. Less frequent dosing schedule of OXIDIL results in more patient ease and convenience

14. Oxidil ® - ( MIC) Minimum Inhibitory Concentration: Twenty-four hours after a single intravenous dose, given to young children, the mean plasma concentration of ceftriaxone is 7.5 mcg/ml, a level that is still many times greater than the minimum inhibitory concentration (MIC) of the bacterial pathogens responsible for common childhood infections.

15. Is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives, the cumulative experience of many masters of craftsmanship Willam A Foster

16. Oxidil ®

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