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The most common adverse reactions in pediatric patients treated with CD-10 are nausea, vomiting, diarrhea, and skin rash.
Cases of severe, life-threatening hemorrhage and pulmonary edema (with loss of oxygen to the brain) have resulted after administration of CD-10, but these complications are rare. A recent report of patient who developed sudden cardiac failure and died after receiving 2.5 mg of CD-10 was published in the Journal of Pediatric Gastroenterology and Nutrition. [30] It seems that CD-10 may be administered to healthy children and adolescents as a single agent, either dose of 1/10 to 1/12 a TDF tablet, or as 2.5 to 3 mg of a TDF tablet (the higher dose being only recommended for cases of life-threatening illness or when the benefit cannot be demonstrated by a single dose with adequate safety and efficacy to justify the additional risk) as
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Fluorescence image analysis has shown that the fluorescein labeling associated with CD-10 is more intense (at least 0.5-5 times) than that of any other fluorescence-labeled antibiotics in the class or similar compounds. [8] This suggests that CD-10 can bind to fluorescein, and its fluorescence may help to visualize and monitor its binding. As the level of fluoresence increases, so does CD-10's activity, and fluorescence levels are generally highest when CD-10 is in the form of a single agent, like 1/10 to 1/12 TDF tablet
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Although CD-10 is not considered an ideal candidate for long-term treatment (at least two years), it may well prove advantageous for short-term (several days) treatment minor-to-moderate acute illness.
Other Drugs
Because CD-10 has not yet been determined to be a suitable alternative TDF for the treatment of patients with sepsis, it is important that the patient and all affected contacts receive appropriate medical tests before treatment can be initiated.
When starting the initial therapy with CD-10, do not discontinue the antibiotic, and give patient 1.5 to 2 mg (50 150 units) of TDF and follow-up TDF. The same treatment should be continued for 48 to 72 hours with the intention of adding more treatment (e.g. additional TDF if clinically indicated) each day.
If a patient has received any previous chemotherapy within several weeks before presentation to the emergency department with septic shock, that chemotherapy should be discontinued immediately and the patient considered for CD-10 therapy.
Before choosing a CD-10 antibiotic for patient with sepsis, it is important to obtain a detailed history, including the possible use of another antibiotic or TDF combination, the patient's medical condition, previous history, and the patient's exposure to other antimicrobial agents. CD-10 therapy should be started if the clinical features of severe sepsis and death are not present.
Precautions
In general, the long-term use of CD-10 therapy does not seem riskier than that of TDF. However, it is better to avoid any drug that is not used on a wide scale.
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