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Metronidazole
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Metronidazole is a narrow spectrum antibiotic with undoubted efficacy against common anaerobic bacteria; resistance is unusual. Therapeutic concentrations of the drug are attained throughout most body compartments after either oral or intravenous administration. The limited side effects of metronidazole are generally tolerable, transient, or reversible. Clinically, metronidazole is as effective as clindamycin and probably chloramphenicol against anaerobes. It has a definite advantage over clindamycin in CNS infections since clindamycin does not penetrate the CSF well. Metronidazole has no irreversible hematologic toxicities, nor has pseudomembranous colitis been definitely attributed to intravenous use of the drug.
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Metronidazole is an imidazole antibiotic that is used in the treatment of many protozoal and bacterial infections. It is available in various forms and strengths, including tablets, suspensions, solutions for injections, suppositories and topical creams and gels. For skin conditions, topical metronidazole is indicated for the treatment of rosacea. In New Zealand topical metronidazole is a prescription medicine and is available as a 7.5 mg/g aqueous gel and cream. The brand name of these preparations is Rozex®.
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Metronidazole has disulfiram-like action and patients reported abdominal distress, nausea, vomiting, flushing, headache and abdominal distress if they drank alcohol during treatment. Confusional and psychotic states have developed when disulfiram and metronidazole are used together. Intravenous "flagyl" infusion is incompatible with cefamandole naftate, cefoxitin sodium, penicilllin potassium (Olsen & Hebjorn, 1982), dextrose 10%, Hartmann solution, hydrocortisone/sodium succinate. Use of liver microsomal enzyme inducers like phenobarbitone and phenytoin has resulted in reducing the half-life and increasing the metabolism of metronidazole. While drugs like cimetidine which decrease liver microsomal enzyme activity result in prolongation of half-life and decrease plasma clearance of metronidazole. Metronidazole is ... reported to potentiate the anticoagulant action of coumarin anticoagulants leading to prolonged prothrombin time.
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Metronidazole has antiprotozoal activity against Trichomonas vaginalis and other protozoa, including Entamoeba histolytica and Giardia lamblia. It does not affect the acidophilic flora of the vagina and it has no effect on Candida species. Metronidazole has bactericidal activity against obligate anaerobic bacteria, whether they are gram-positive or negative and bacilli or cocci. It has no antibacterial activity against aerobic and facultative anaerobic bacteria. Metronidazole does not interfere with the activity of antibacterial agents which are active against a variety of aerobes and facultative anaerobes.
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Metronidazole is active against a wide variety of bacteria that do not require oxygen to grow. These are known collectively as anaerobic bacteria. There are many types of anaerobic bacteria that cause various types of infections affecting areas of the body such as the bones, gut, pelvis and gums. Metronidazole is used to treat these infections. It is ... used to treat leg ulcers and pressure sores that are infected with anaerobic bacteria, and to prevent infection following surgery, particularly gynaecological surgery and surgery on the gut, where many anaerobic bacteria may be found. In high doses metronidazole penetrates the brain and is used to treat abscesses occuring there.
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Metronidazole works by entering bacterial and protozoal cells and interfering with their genetic material (DNA). It damages the DNA and ... prevents the bacteria and protozoa from forming new DNA. This ultimately results in metronidazole killing the micro-organisms, which clears up the infection.
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Metronidazole