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Metronidazole: Treatment of Anaerobic and Parasitic Infections

Mechanism of Action of Metronidazole

Metronidazole is a nitroimidazole antibiotic, which is effective against anaerobic bacteria and protozoa (Simon und Stille, 1997).

Antibiotic spectrum of metronidazole:

Metronidazole is sensitive against almost obligate anaerobic bacteria, and against protozoa such as Trichomonas, Giardia lamblia and Entamoeba.

Urological indications for Metronidazole:

• Combined application of metronidazole with e.g., cephalosporins in severe intra-abdominal infections
• Perioperative antibiotic prophylaxis in combination with a cephalosporin for procedures with opening of the colon
• Trichomoniasis
• Amoebiasis
• Giardiasis
• Pseudomembranous enterocolitis caused by Clostridium difficile
• Bacterial vaginosis
• Combined application of metronidazole with e.g., cephalosporins in severe pelvic inflammatory disease

Pharmacokinetics of Metronidazole:

Good oral absorption or parenteral administration, elimination half life 7 h, renal excretion 30%.

Side effects of Metronidazole:

Gastointestinal tract:

Nausea, vomiting, diarrhea, pancreatitis.

CNS:

Dizziness, ataxia, convulsions, peripheral neuropathy.

Other organ systems:

Rashes, itching, reversible neutropenia.

Contraindications of Metronidazole:

Pregnancy, alcohol consumption.

Interactions of Metronidazole:

Metronidazole may elevate blood levels of warfarin and lithium. Metronidazole causes a severe alcohol intolerance.

Dosage of Metronidazole:

Intravenous dosage 0.5 g i.v. 1-0-1 or single dose perioperatively. Oral dosage 0.4 g 1-1-1 or 0.5 g 1-0-1.

Trade names of metronidazole:

Arilin, Clont, Flagyl, Mepagyl, Nidagyl, Infectoclont, Vagimid.

References

Simon und Stille 1997 SIMON, C. ; STILLE, W.: Antibiotika-Therapie in Klinik und Praxis.
9. Auflage.
Stuttgart New York : Schattauer, 1997

  Deutsche Version: Metronidazol