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Halsey)Tj 10 0 0 10 70.85001 660.79491 Tm [(Specialty Pharmacy Coordinator)56.56433 (, )56.62537 (Aurora W)19.80591 (e)1.72424 (st )57.00684 (Allis Medical Center)57.58667 (, 8901 W)20.64514 (est Lincoln )58.16650 (A)21.13342 (venue, W)21.39282 (est)45.08972 ( )]TJ 10 0 0 10 70.85001 649.79485 Tm [(Allis, Wisconsin 53227.)42.81616 ( )]TJ /F3 1 Tf 10 0 0 10 70.85001 629.74480 Tm 0.00250 Tc (Abstract:)Tj /F4 1 Tf 10 0 0 10 111.61798 629.74480 Tm 0.12500 Tw ( Nitazoxanide is a broad-spectrum agent active against several protozoa, helminths, and bacteria, including )Tj /F5 1 Tf 10 0 0 10 70.85001 618.74474 Tm 0 Tc 0.01860 Tw (C. dif)Tj /F6 1 Tf 10 0 0 10 93.26303 618.74474 Tm 0 Tw ()Tj /F5 1 Tf 10 0 0 10 95.76303 618.74474 Tm ( cile)Tj /F4 1 Tf 10 0 0 10 112.69708 618.74474 Tm 0.01860 Tw ( and )Tj /F5 1 Tf 10 0 0 10 132.50803 618.74474 Tm (H. pylori)Tj /F4 1 Tf 10 0 0 10 168.80304 618.74474 Tm [(. It is available as an oral tablet and suspension, both with adequate bioavailability)68.03894 (. Nitazoxanide )]TJ 10 0 0 10 70.85001 607.74467 Tm -0.00500 Tw [(is associated with minimal side ef)19.24133 (fects, has an acceptable safety pro)]TJ /F7 1 Tf 10 0 0 10 341.45502 607.74467 Tm 0 Tw ()Tj /F4 1 Tf 10 0 0 10 344.23608 607.74467 Tm -0.00500 Tw [( )-30.99060 (le, and has been classi)]TJ /F7 1 Tf 10 0 0 10 435.39407 607.74467 Tm 0 Tw ()Tj /F4 1 Tf 10 0 0 10 438.17514 607.74467 Tm -0.00500 Tw [( )-30.41077 (ed as a pregnancy category B )]TJ 10 0 0 10 70.85016 596.74461 Tm 0.00320 Tc 0.12500 Tw (agent. It is 99% protein bound, which could result in drug interactions. It is the preferred agent for the treatment of )Tj 10 0 0 10 70.85016 585.74455 Tm 0 Tc 0.00110 Tw (Cryptospordiosis and Giardiasis in immunocompetent patients and has shown promise for the treatment of rotavirus, mild )Tj 10 0 0 10 70.85016 574.74449 Tm 0 Tw (to moderate initial )Tj /F5 1 Tf 10 0 0 10 146.66116 574.74449 Tm (C. dif)Tj /F6 1 Tf 10 0 0 10 168.88818 574.74449 Tm ()Tj /F5 1 Tf 10 0 0 10 171.38818 574.74449 Tm ( cile)Tj /F4 1 Tf 10 0 0 10 188.32117 574.74449 Tm ( infection, refractory )Tj /F5 1 Tf 10 0 0 10 273.27722 574.74449 Tm (C. dif)Tj /F6 1 Tf 10 0 0 10 295.50424 574.74449 Tm ()Tj /F5 1 Tf 10 0 0 10 298.00424 574.74449 Tm ( cile)Tj /F4 1 Tf 10 0 0 10 314.93723 574.74449 Tm [( infection, )57.37305 (Amoebiasis, Blastocystosis, and )]TJ /F5 1 Tf 10 0 0 10 488.80930 574.74449 Tm [(T)94.80286 (aenia saginata)]TJ /F4 1 Tf 10 0 0 10 552.61835 574.74449 Tm (.)Tj /F3 1 Tf 10 0 0 10 70.85031 554.69444 Tm (Keywords:)Tj /F4 1 Tf 10 0 0 10 117.51031 554.69444 Tm ( nitazoxanide, gastrointestinal, cryptosporidiosis, giardiasis, )Tj /F5 1 Tf 10 0 0 10 359.41034 554.69444 Tm (clostridium dif)Tj /F6 1 Tf 10 0 0 10 418.02332 554.69444 Tm ()Tj /F5 1 Tf 10 0 0 10 420.52332 554.69444 Tm ( cile)Tj /F4 1 Tf 10 0 0 10 437.45630 554.69444 Tm (, rotavirus)Tj /F2 1 Tf 14 0 0 14 70.85001 521.69490 Tm (Introduction)Tj /F4 1 Tf 12 0 0 12 70.85001 508.69501 Tm 0.00900 Tc 0.12500 Tw (Diarrheal illness is a signi)Tj /F7 1 Tf 12 0 0 12 204.50363 508.69501 Tm 0 Tc 0 Tw ()Tj /F4 1 Tf 12 0 0 12 207.94766 508.69501 Tm 0.00900 Tc 0.12500 Tw [( )104.81262 (cant worldwide cause of morbidity and mortality)62.63733 (. )15.71655 (Those resulting in)6.14929 ( )]TJ 12 0 0 12 70.85001 495.69543 Tm 0 Tc 0.05820 Tw (gastrointestinal illness are greatest in developing countries due to the various routes of transmission )Tj 12 0 0 12 70.85001 482.69586 Tm -0.00180 Tc 0 Tw (speci)Tj /F7 1 Tf 12 0 0 12 95.40079 482.69586 Tm 0 Tc ()Tj /F4 1 Tf 12 0 0 12 98.71646 482.69586 Tm -0.00180 Tc -0.06250 Tw [( )-92.92603 (cally tied to hygiene \(T)68.81714 (able 1\). )16.72363 (The )16.61682 (W)78.58276 (orld Health Or)16.32690 (ganization estimates that each child )]TJ /F8 1 Tf 12 0 0 12 514.73245 482.69586 Tm 0 Tc 0 Tw ()Tj /F4 1 Tf 12 0 0 12 524.70804 482.69586 Tm -0.00150 Tc -0.06281 Tw (4 years )Tj 12 0 0 12 70.85001 469.69629 Tm 0 Tc -0.03619 Tw [(old will have an average of 3.2 diarrheal episodes per year)53.43628 (. )16.29639 (While mortality rates attributed to diarrheal )]TJ 12 0 0 12 70.85001 456.69672 Tm 0.01790 Tw (illness have declined, the associated mortality rate is still 3.8 deaths per 1,000 children )Tj /F8 1 Tf 12 0 0 12 492.07278 456.69672 Tm 0 Tw ()Tj /F4 1 Tf 12 0 0 12 502.06870 456.69672 Tm 0.01790 Tw (4 years old. )Tj 12 0 0 12 70.84982 443.69714 Tm -0.00529 Tc -0.06250 Tw (Diarrheal illness can lead to malnutrition, a signi)Tj /F7 1 Tf 12 0 0 12 296.26254 443.69714 Tm 0 Tc 0 Tw ()Tj /F4 1 Tf 12 0 0 12 299.53500 443.69714 Tm -0.00529 Tc -0.06250 Tw [( )-97.44263 (cant mortality cause in developing countries especially)-8.16345 ( )]TJ 12 0 0 12 70.84982 430.69757 Tm 0 Tc 0 Tw (in those patients infected with Human Immunode)Tj /F7 1 Tf 12 0 0 12 308.13071 430.69757 Tm ()Tj /F4 1 Tf 12 0 0 12 311.46799 430.69757 Tm 0.02811 Tw [( ciency )44.41833 (V)58.27332 (irus )26.16882 (\(HIV\).)]TJ 12 0 0 12 85.00040 417.69800 Tm 0.07880 Tw [(Overall, according to the )16.92200 (W)78.94897 (o)-1.15967 (rld Health Or)16.60156 (ganization, protozoal and helminth infections result in )]TJ 12 0 0 12 70.85001 404.69843 Tm 0.01421 Tw (gastrointestinal illness for over 450 million patients. Both immunocompetent and immunosuppressed )Tj 12 0 0 12 70.85001 391.69885 Tm 0.06850 Tw [(patients are at risk. )17.15088 (While traditional therapies continue to be moderately ef)]TJ /F7 1 Tf 12 0 0 12 441.54446 391.69885 Tm 0 Tw ()Tj /F4 1 Tf 12 0 0 12 444.88174 391.69885 Tm 0.06850 Tw [( )38.11646 (cacious, new therapies )]TJ 12 0 0 12 70.85019 378.69928 Tm 0 Tw (must be developed due to increasing resistance.)Tj /F2 1 Tf 14 0 0 14 70.85001 345.69501 Tm (Evaluation and Diagnosis of Diarrheal Illness)Tj /F4 1 Tf 12 0 0 12 70.85001 332.69501 Tm -0.00110 Tw (Diarrheal illness can be classi)Tj /F7 1 Tf 12 0 0 12 213.40878 332.69501 Tm 0 Tw ()Tj /F4 1 Tf 12 0 0 12 216.74478 332.69501 Tm -0.00110 Tw [( )-30.33447 (ed as acute \()]TJ /F8 1 Tf 12 0 0 12 279.67392 332.69501 Tm 0 Tw ()Tj /F4 1 Tf 12 0 0 12 289.66873 332.69501 Tm -0.00110 Tw ( 14 days in duration\), persistent \()Tj /F8 1 Tf 12 0 0 12 447.89236 332.69501 Tm 0 Tw ()Tj /F4 1 Tf 12 0 0 12 457.88828 332.69501 Tm -0.00110 Tw (14 days\) and chronic )Tj 12 0 0 12 70.84872 319.69543 Tm 0 Tw (\()Tj /F8 1 Tf 12 0 0 12 74.84464 319.69543 Tm ()Tj /F4 1 Tf 12 0 0 12 84.84055 319.69543 Tm 0.04050 Tw (30 days\). Most cases of acute diarrhea are self-limiting and require only supportive care. Primary )Tj 12 0 0 12 70.84854 306.69586 Tm 0.06979 Tw [(causes of acute diarrhea include viruses, bacteria and rarely protozoa. )15.99121 (When a patient presents with )]TJ 12 0 0 12 70.84854 293.69629 Tm 0 Tw (diarrhea, a thorough physical exam and careful history should be taken to determine:)Tj /F9 1 Tf 12 0 0 12 70.84854 274.69672 Tm ()Tj /F4 1 Tf 12 0 0 12 76.36862 274.69672 Tm [( )-469.60449 (Diarrhea duration, frequency)63.75122 (, and consistency \(including whether blood is present\))]TJ /F9 1 Tf 12 0 0 12 70.84854 261.69714 Tm ()Tj /F4 1 Tf 12 0 0 12 76.36862 261.69714 Tm [( )-469.60449 (Number of vomiting episodes)]TJ /F9 1 Tf 12 0 0 12 70.84854 248.69757 Tm ()Tj /F4 1 Tf 12 0 0 12 76.36862 248.69757 Tm [( )-469.60449 (Medications patient is currently taking including recent antibiotic use)]TJ /F9 1 Tf 12 0 0 12 70.84854 235.69800 Tm ()Tj /F4 1 Tf 12 0 0 12 76.36862 235.69800 Tm 0.46919 Tw ( Comorbidities)Tj /F9 1 Tf 12 0 0 12 70.84854 222.69843 Tm 0 Tw ()Tj /F4 1 Tf 12 0 0 12 76.36862 222.69843 Tm [( )-469.60449 (Factors that could have exposed the patient to enteric pathogens including:)]TJ 12 0 0 12 70.84854 209.69885 Tm ( )Tj /F10 1 Tf 7 0 0 7 82.85001 209.69501 Tm ({)Tj /F4 1 Tf 12 0 0 12 89.08780 209.69501 Tm 0.48019 Tw ( Residence)Tj 12 0 0 12 70.85013 196.69543 Tm 0 Tw ( )Tj /F10 1 Tf 7 0 0 7 82.85001 196.69501 Tm ({)Tj /F4 1 Tf 12 0 0 12 89.08780 196.69501 Tm 0.48019 Tw [( T)34.65271 (ravel )479.49219 (history)]TJ 12 0 0 12 70.85013 183.69543 Tm 0 Tw ( )Tj /F10 1 Tf 7 0 0 7 82.85001 183.69501 Tm ({)Tj /F4 1 Tf 12 0 0 12 89.08780 183.69501 Tm [( )-480.66711 (Presence of pets or other animals)]TJ /F9 1 Tf 12 0 0 12 70.85013 170.69543 Tm ()Tj /F4 1 Tf 12 0 0 12 76.37021 170.69543 Tm 0.46919 Tw [( Food )468.59741 (history)]TJ ET q 113.98000 95.04300 -43.13000 -14.70300 re 70.85001 95.04300 m W n q /GS1 gs 43.17601 0 0 14.73599 70.82698 80.32198 cm /X0 Do Q Q Q BT /F11 1 Tf 8 0 0 8 70.85001 32.87300 Tm 0 0 0 1 k /GS2 gs [(Clinical Medicine:)100.09766 ( )125 (Thera)9.81140 (peutics 2009:)100.09766 (1 263275)]TJ ET endstream endobj 166 0 obj <> endobj xref 0 167 0000000000 65535 f 0000000016 00000 n 0000000202 00000 n 0000000460 00000 n 0000003375 00000 n 0000003561 00000 n 0000003769 00000 n 0000008280 00000 n 0000008466 00000 n 0000008685 00000 n 0000012732 00000 n 0000021601 00000 n 0000021874 00000 n 0000022063 00000 n 0000022258 00000 n 0000026434 00000 n 0000026623 00000 n 0000026818 00000 n 0000031080 00000 n 0000031269 00000 n 0000031464 00000 n 0000035872 00000 n 0000036061 00000 n 0000036256 00000 n 0000040339 00000 n 0000040528 00000 n 0000040736 00000 n 0000044872 00000 n 0000045061 00000 n 0000045308 00000 n 0000049725 00000 n 0000049914 00000 n 0000050148 00000 n 0000054535 00000 n 0000054724 00000 n 0000054921 00000 n 0000060962 00000 n 0000061151 00000 n 0000061338 00000 n 0000068666 00000 n 0000079687 00000 n 0000079973 00000 n 0000080198 00000 n 0000080510 00000 n 0000080688 00000 n 0000080968 00000 n 0000081381 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