1. Ceftriaxone 1gm & 250mg I.V. & I.M.
OFRAMAX
Ceftriaxone
1gm & 250mg
I.V. & I.M.

2. Introduction OFRAMAX is a broad spectrum antibiotic.
OFRAMAX has all the qualities required in modern treatment of extremely severe bacterial infections:
Unequalled antibacterial activity against a large number of microorganisms, including certain ‘problem’ bacteria responsible for hospital-acquired infections and resistant to traditional cephalosporins & aminoglycosides.
Rapid diffusion to the site of infection, into tissue, cerebrospinal fluid & abscesses.
No metabolism in the body.
Resistant to B-lactamases.
Safety.
Reliability for both the doctor & patient.

3. Introduction
OFRAMAX maintains effective antibacterial concentrations in the body over a period of 24 hours so that it can be administered in a single daily dose.
This is of considerable advantage to both patient and nursing staff.
OFRAMAX offers the physician greater security and the patient greater convenience.

4. Antimicrobial Spectrum
Aerobes
Gram-negative micro-organisms:
H. influenzae, Neisseria meningitidis, N. gonorrhoeae, P. mirabilis, Serratia marcescens, Salmonella typhi & paratyphi, E. coli, Klebsiella and Moraxella.
Gram-positive micro-organisms:
Staph. aureus, Streptococcus pneumoniae and Streptococcus viridans
Anaerobes
Bacteroids, Clostridium, Fusobacterium, Peptococcus and Peptostreptococcus.

5. Mechanism of Action
OFRAMAX shows a strong affinity for penicillin-binding proteins.
Inactivation of these proteins causes lysis of the bacterial cell wall.
OFRAMAX is bactericidal in action.

6. Synergism
The combination of OFRAMAX with aminoglycosides (e.g. gentamycin, tobramycin or amikacin) has a marked synergistic effect against Pseudomonas aeroginosa .

7. Bioavailability & Plasma conc.
Bioavailability of OFRAMAX I.M. = I.V. = 100%.
Plasma concentrations after I.V. and I.M. administration are almost identical.
OFRAMAX retains therapeutic conc. over long periods of time
(Even after 24 hours, these are several times higher than the MIC of most pathogens).

8. Protein binding Ceftriaxone is reversibly bound to albumin.
The protein-bound OFRAMAX acts as a reservoir and is one of the factors contributing to its long elimination half-life (8 hours).

9. Distribution in the body
OFRAMAX diffuses rapidly into the interstitial fluid, and reaches the site of numerous infections in bactericidal concentrations after I.V. or I.M. administration.
OFRAMAX readily crosses the Blood Brain Barrier, and can be used in the treatment of bacterial meningitis.
OFRAMAX shows excellent penetration into bone tissue.
The prolonged contact with microorganisms gives OFRAMAX the advantage over other cephalosporins.

10. Penetration into the Cerebrospinal fluid (C.S.F.)
Infants & Children:
OFRAMAX penetrates the inflamed meninges of infants & children.
The average extent of diffusion in the CSF in bacterial meningitis is approximately 4 times that in aseptic meningitis.
Adults:
Administration of OFRAMAX 50 mg/kg leads to CSF conc. several times higher than the MIC required for the most common causative organisms of meningitis.
Its long duration and high conc. in the CSF make OFRAMAX the drug of choice in the treatment of bacterial meningitis.

11. Passage across the placental barrier
Pregnant women were given 1.5 gm Ceftriaxone in ½ hour infusion every 24 hours.
The concentrations of Ceftriaxone in the amniotic fluid remained fairly constant.
OFRAMAX crosses the placental barrier.

12. Penetration into bones

13. Metabolism & Excretion
OFRAMAX is excreted unchanged in the urine and the bile.
OFRAMAX is excreted as follows:
2/3 via the kidneys.
1/3 via the gallbladder.

14. Elimination in renal or hepatic insufficiency
Renal insufficiency:
Renal insufficiency does not necessitate an adjustment of the dosage as long as it does not exceed 2 gm / day.
Assuming normal hepatic function, the reduced excretion via the kidneys is compensated by increased biliary clearance.
Hepatic insufficiency:
In case of severe liver parenchymal damage, increased renal elimination compensates the hepatic insufficiency.
Dose adjustment is necessary only in case of simultaneous severe renal & hepatic function disorders.

15. Indications OFRAMAX is indicated in the following severe indications:
Sepsis & severe septic conditions.
Endocarditis.
Meningitis.
GIT & Intra abdominal infections.
Urinary tract infections.
Pneumonia.
Lower RTI.
ENT infections.
Bone & Joint infections.
Skin & soft tissue infections.
Sexually transmitted diseases.
Surgical infections: prophylaxis & treatment.

16. Dose Once Daily. This offers the following privileges:
Patient compliance.
Easier for the nursing staff.
Earlier discharge from hospital.
Lowered risk of infections.
Considerable social benefit.
Saving in health costs.

17. OFRAMAX in surgical prophylaxis
A single 1 – 2 gm dose of OFRAMAX is an effective prophylactic measure against infection at surgery, and its long duration of action enhances the drug’s reliability.
OFRAMAX is recommended in a single dose of 1gm (in surgery with low risk of infection), or 2gm (in surgery with high risk of infection) for prophylaxis of perioperative infections.

18. OFRAMAX in Sepsis & Septic conditions (including Endocarditis)
OFRAMAX can be used for treating sepsis & septic conditions in a daily dose of 2 gm.
The once daily dosage can help in discharging the patient from hospital sooner, and hence reduce the health care costs.

19. OFRAMAX in Meningitis
OFRAMAX is characterized by:
Outstanding efficacy against the major pathogens involved in meningitis.
Good penetration into CSF.
Treatment period of days.
OFRAMAX is considered the drug of choice in the treatment of Meningitis.

20. OFRAMAX in Respiratory Tract Infections
OFRAMAX is significantly superior to other antimicrobials in the treatment of Pneumonia and Severe Bronchitis.
A further advantage is the Once Daily dosage of OFRAMAX.
OFRAMAX is effective even where other antimicrobials have failed to cure very seriously ill patients.

21. OFRAMAX in E.N.T. and Jaw Infections
OFRAMAX, administered once daily at a dose of 1 gm, can be recommended for severe jaw and ear, nose & throat infections.
The duration of treatment is 5 – 10 days.

22. OFRAMAX in G.I.T. Infections
Peritonitis %
Biliary infection 90%
Typhoid fever 96%

23. OFRAMAX in Urinary Tract Infections
OFRAMAX shows very good Cure rates with 1-2 gm once daily dose for one week.
Patients previously treated unsuccessfully with other antibiotics respond well to OFRAMAX.
OFRAMAX is superior to comparable antimicrobials even when administered in low doses and once daily.

24. Safety
OFRAMAX is safe & well tolerated even after repeated administration.
OFRAMAX shows no nephrotoxic.
OFRAMAX shows no embryotoxicity, teratogenicity or mutagenic effects.

25. Side Effects OFRAMAX is very well tolerated.
The incidence of occurrence of undesirable side effects is only 0.6%.

26. Competition Ceftriaxone 1gm: Rocephin (Roche) 46.00 L.E.
OFRAMAX (RANBAXY) L.E.
Rocephin (Roche) L.E.
Cefotrix (T3A) L.E.
Epicephin (Eipico) L.E.

27. Competition (…cont.) Cefotaxime 1gm: Claforan (Aventis) 25.75 L.E.
Cefotax (T3A) L.E.
Cefotax (Eipico) L.E.
Ceforan (Pharco) L.E.
Cefaxim (El-Nasr) L.E.
Cefoperazone 1gm:
Cefobid (Pfizer) L.E.
Cefazone (Pharco) L.E.
Cefozone (Eipico) L.E.
Peracef (T3A) L.E.
Ceftazidime 1gm:
Fortum (GSK) L.E.
Cetazime (T3A) L.E.

28. Target Audience I.V. Surg. 1st 100 % I.M. Surg. 1st 30 %
Target Audience Priority % of Calls
I.V.
Surg. 1st %
I.M.
Surg. 1st 30 %
Chest 2nd 30 %
Ped. 3rd 20 %
Int./G.P. 4th 20 %

29. Major Selling Points
OFRAMAX maintains effective antibacterial concentrations in the body over a period of 24 hours, hence given Once daily.
3rd generation ceph. with Unequalled antibacterial activity against large number of microorganisms, thus, suitable for wide range of infections.
Rapid diffusion to the site of infection, into tissue, cerebrospinal fluid & abscesses, hence high & rapid cure rate.
OFRAMAX is bactericidal in action, thus offering high & rapid cure rate, with no recurrence of infection.

30. Major Selling Points
The combination of OFRAMAX with aminoglycosides (e.g. gentamycin, tobramycin or amikacin) has a marked synergistic effect against Pseudomonas aeroginosa .
OFRAMAX is safe & well tolerated even after repeated administration, with no nephrotoxic, embryotoxic, teratogenic or mutagenic effects.
OFRAMAX is considered the drug of choice in the treatment of Meningitis.
OFRAMAX offers the physician greater security and the patient greater convenience.

31. BEST OF LUCK