1. The innovative Swiss pharmaceutical company Mesporin: Mepha Health Care.. for Post-operative Infection

2. Headline of the presentation / May 15, 2015 / Page 2 Postoperative Infections, Simple Facts The innovative Swiss pharmaceutical company

3. Headline of the presentation / May 15, 2015 / Page 3 ■ The most common postoperative infections include: - Local infection: Surgical site (wound) infection, Intra-abdominal infection & abcess, - Remote infections: Respiratory tract infection, Urinary tract infection,  The rates of surgical site and respiratory infections are less with laparoscopic surgery; however, in some studies laparoscopic surgery seems to cause a higher incidence of postoperative intra- abdominal abscess¹. 1: Boni et al; Infective Complications in Laparoscopic Surgery. Surgical Infections. Summer 2006, 7(supplement 2): s-109-s-111. The innovative Swiss pharmaceutical company

4. Headline of the presentation / May 15, 2015 / Page 4 Preventing Surgical Infections Antibiotic prophylaxis ■ Drugs: which, when, how many doses? Non antibiotic measures- evidence based: ■ Hair removal ■ Normothermia ■ Oxygen supplementation ■ Normoglycemia

5. Headline of the presentation / May 15, 2015 / Page 5 Antibiotic rationale – what should we choose? ■ Deal with the common pathogens encountered at the surgical site ■ One that is bactericidal ■ One that achieves adequate local soft tissue concentrations ■ One that is non toxic with minimal side effects ■ One that has a long serum half life ■ Ideally one that has a low risk of inducing resistance The innovative Swiss pharmaceutical company

6. Headline of the presentation / May 15, 2015 / Page 6 For such serious need in surgery… has developed an innovative antibiotic.. The innovative Swiss pharmaceutical company

7. Headline of the presentation / May 15, 2015 / Page 7 Ceftriaxone Prophylaxis General & Gynecological Surgery The innovative Swiss pharmaceutical company

8. Headline of the presentation / May 15, 2015 / Page 8 ■ Postsurgical infections varies in site, severity, & causative micro-organisms. ■ Therefore, 2 or 3 antibiotic combinations are usually used, as well as broad & ultra-broad spectrum antibiotic monotherapy. ■ To evaluate the role of surgical prophylaxis with ceftriaxone versus other antibiotics, a meta-analysis of 48 clinical studies were performed involving 17, 565 patients*. The innovative Swiss pharmaceutical company * Esposito et al; Ceftriaxone versus Other Antibiotics for Surgical Prophylaxis: A Meta-Analysis. Clinical Drug Investigation: 2004 - Volume 24 - Issue 1 - pp 29-39.

9. Headline of the presentation / May 15, 2015 / Page 9 Results: The innovative Swiss pharmaceutical company Incidence of postoperative infections

10. Headline of the presentation / May 15, 2015 / Page 10 Conclusions: ■ The meta-analysis showed that ceftriaxone is statistically superior to other antibiotics in preventing both local and remote postoperative infections. The innovative Swiss pharmaceutical company

11. Headline of the presentation / May 15, 2015 / Page 11 The antibiotic of choice Once daily therapy The innovative Swiss pharmaceutical company

12. Headline of the presentation / May 15, 2015 / Page 12 Mesporin TM is a sterile, lyophilized, semi-synthetic, long-acting, parenteral (intravenous and intramuscular), broad-spectrum bactericidal antibiotic. The chemical formula of ceftriaxone sodium References: Zimmermanns M. Index Infektionen Erreger Antibiotika. 1989

13. Headline of the presentation / May 15, 2015 / Page 13 The bactericidal activity of ceftriaxone results from inhibition of the bacteria’s wall synthesis. Ceftriaxone exerts activity against both Gram-negative and Gram-positive aerobic and wide range of anaerobic microorganisms. Ceftriaxone is highly stable to most β-lactamases, both penicillinases and cephalosporinases, of Gram-negative and Gram-positive bacteria. Properties and effects References: Zimmermanns M. Index Infektionen Erreger Antibiotika. 1989

14. Headline of the presentation / May 15, 2015 / Page 14 Half-life of ceftriaxone is generally about 6 to 10 hours in healthy adult subjects. The exceptional pharmacokinetic characteristics of ceftriaxone (Mesporin TM ) supports a once-daily dosing in every clinical conditions and patient age. A high plasma and tissue concentration after both i.v. and i.m. administration simplifies the treatment and ensures an effective bactericidal tissue concentration during 24 hours. Pharmacokinetics of ceftriaxone References: Physician’s Desk Reference. 54th edition, 2000 Borgden R., Ward A. Drugs. 1988;35;604–645 Patel I. et al. Antimicrob Agents Chemother. 1981;20;634–641 Stoeckel et al. Current Chemotherapy and immunotherapy. 1982;Vol.1;454–455

15. Headline of the presentation / May 15, 2015 / Page 15 The innovative Swiss pharmaceutical company The antibiotic of choice  Compensatory excretion through the kidney and liver prevents accumulation in case of impairment of one or the other.  Dual and balanced excretion Via Renal and Biliary pathways

16. Headline of the presentation / May 15, 2015 / Page 16 Why Mesporin? The innovative Swiss pharmaceutical company ONCE DAILY TOP SWISS QUALITY Lyophilized ceftriaxone Deep tissue penetration Dual excretion pathways

17. The innovative Swiss pharmaceutical company Thank You