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Metronidazole (Flagyl)
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Metronidazole

Flagyl is an oral antiprotozoal and antibacterial. It is thought to work by entering the bacterial cell, acting on some components of the cell, and destroying the bacteria. Treating certain infections caused by bacteria or amoebas. It may also be used for other conditions as determined by your doctor.

Other names for this medication:
Acuzole, Amodis, Amrizole, Anazol, Aristogyl, Bemetrazole, Birodogyl, Diazole, Dumozol, Elyzol, Entizol, Etron, Filmet, Flagenase, Flagyl, Flagystatin, Flazol, Gynotran, Klion, Medazol, Metazol, Metrazol, Metris, Metrocream, Metrogel, Metrogyl, Metrolag, Metrolotion, Metronidazol, Metronide, Metropast, Metrosa, Metrovax, Metrozine, Negazole, Nidagel, Nidazol, Nidazole, Nizole, Noritate, Onida, Orvagil, Protogyl, Rhodogil, Riazole, Rodogyl, Rozex, Stomorgyl, Supplin, Trichazole, Triconex, Trogyl, Vagilen, Vandazole, Vertisal, Zidoval

Similar Products:
Amoxil, Bactrim, Ampicillin, Augmentin, Macrobid, Trimox, Tinidazole, Biaxin, Chloromycetin, Myambutol

 

Also known as:  Flagyl.

Description

Metronidazole (generic name: Metronidazole) is an antibiotic that belongs to a group of medicines called nitroimidazoles.

Metronidazole is used for the treatment of susceptible anaerobic bacterial and protozoal infections in the following conditions: amebiasis, symptomatic and asymptomatic trichomoniasis; skin and skin structure infections; CNS infections; intra-abdominal infections (as part of combination regimen); systemic anaerobic infections; treatment of antibiotic-associated pseudomembranous colitis (AAPC); bacterial vaginosis; as part of a multidrug regimen for H. pylori eradication to reduce the risk of duodenal ulcer recurrence.

Dosage

The dosage regimen should be individualized. Single-dose treatment can assure compliance, especially if administered under supervision, in those patients who cannot be relied on to con- tinue the seven-day regimen. A seven-day course of treatment may minimize reinfection by pro- tecting the patient long enough for the sexual con- tacts to obtain appropriate treatment. Further, some patients may tolerate one treatment regi- men better than the other.

Overdose

Single oral doses of Metronidazole, up to 15 g, have been reported in suicide attempts and accidental overdoses. Symptoms reported include nausea, vomiting, and ataxia. Oral Metronidazole has been studied as a radiation sensitizer in the treatment of malignant tumors. Neurotoxic effects, including seizures and peripheral neuropathy, have been reported after 5 to 7 days of doses of 6 to 10.4 g every other day.

There is no specific antidote for Metronidazole overdose; therefore, management of the patient should consist of symptomatic and supportive therapy.

Storage

Store at room temperature below 25 degrees C (77 degrees F) away from moisture, light and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Metronidazole are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

To reduce the development of drug-resistant bac- teria and maintain the effectiveness of Metronidazole and other antibacterial drugs, Metronidazole should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

dosage metronidazole treat bv

The activity of faropenem, a new oral penem, was tested against 579 strains of anaerobic bacteria by using the NCCLS-approved reference method. Drugs tested included amoxicillin-clavulanate, cefoxitin, clindamycin, faropenem, imipenem, and metronidazole. Of the 176 strains of Bacteroides fragilis group isolates tested, two isolates had faropenem MICs of 64 micro g/ml and imipenem MICs of >32 micro g/ml. Faropenem had an MIC of 16 micro g/ml for an additional isolate of B. fragilis; this strain was sensitive to imipenem (MIC of 1 micro g/ml). Both faropenem and imipenem had MICs of < or=4 micro g/ml for all isolates of Bacteroides capillosus (10 isolates), Bacteroides splanchnicus (13 isolates), Bacteroides ureolyticus (11 isolates), Bilophila wadsworthia (11 isolates), Porphyromonas species (42 isolates), Prevotella species (78 isolates), Campylobacter species (25 isolates), Sutterella wadsworthensis (11 isolates), Fusobacterium nucleatum (19 isolates), Fusobacterium mortiferum/varium (20 isolates), and other Fusobacterium species (9 isolates). Faropenem and imipenem had MICs of 16 to 32 micro g/ml for two strains of Clostridium difficile; the MICs for all other strains of Clostridium tested (69 isolates) were < or =4 micro g/ml. Faropenem had MICs of 8 and 16 micro g/ml, respectively, for two strains of Peptostreptococcus anaerobius (MICs of imipenem were 2 micro g/ml). MICs were < or =4 micro g/ml for all other strains of gram-positive anaerobic cocci (53 isolates) and non-spore-forming gram-positive rods (28 isolates). Other results were as expected and reported in previous studies. No metronidazole resistance was seen in gram-negative anaerobes other than S. wadsworthensis (18% resistant); 63% of gram-positive non-spore-forming rods were resistant. Some degree of clindamycin resistance was seen in most of the groups tested.

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Between 2002 and 2013, 1995 prospectively recorded episodes of BSI in 1719 patients aged 16-99 years were included. We analyzed the antimicrobial non-susceptibility according to place of acquisition, site of infection, microbe group, and time period.

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Intra or extra orbital cellulitis or abscesses are the most frequent bacterial complications of acute sinusitis. Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus (SA), and anaerobic bacteria are predominant, and more rarelyHaemophilus influenzae (especially since vaccination against type b). Because of bacterial sensitivity, PK/PD parameters of antibiotics, and depending on the classification of Chandler, different probabilistic regimens may be proposed: In class 1 by Chandler (preseptal cellulitis), amoxicillinclavulinate (80 mg/kg/d) in 2 oral doses, and ceftriaxone in intramuscular injection; in cases of class 2 to 5 by Chandler, high doses of intravenous amoxicillin-clavulinate (until 150 mg/kg/d of amoxicillin), or intravenous association of ceftriaxone (100 mg/kg/d) or cefotaxim (200 mg/kg/d), with anti-anaerobic like metronidazole (30 mg/kg/d) or clindamycine (40 mg/kg/d).

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There has been greater interest in developing additional antimicrobial agents due to the increasing health care costs and resistance resulting from bacterial pathogens to currently available treatment options. Gram-negative organisms including Enterobacteriaceae and Pseudomonas aeruginosa are some of the most concerning threats due to their resistance mechanisms: extended-spectrum beta-lactamase production and Klebsiella pneumoniae carbapenemase enzymes. Ceftazidime is a third-generation broad-spectrum cephalosporin with activity against P. aeruginosa and avibactam is a novel nonbeta-lactam beta-lactamase inhibitor. Avycaz(®), the trade name for this new combination antibiotic, restores the activity of ceftazidime against some of the previously resistant pathogens. Avycaz was approved in 2015 for the treatment of complicated urinary tract infections, including pyelonephritis, and complicated intra-abdominal infections with the addition of metronidazole in patients with little to no other treatment options. This review article assesses the clinical trials and data that led to the approval of this antibiotic, in addition to its spectrum of activity and limitations.

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Studies evaluating RBC plus two antibiotics were considered. For the meta-analysis, randomized controlled trials comparing PPI vs. RBC plus two antibiotics for 1 week were included.

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To assess the probability of achieving effective PK/PD relationship with the administration of 1,000 mg every 24 hours of metronidazole for Bacteroides fragilis infections.

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The objective of this study was to characterize the relationship between gentamicin concentrations during surgery and the development of wound infection following colorectal operations. Despite decades of research in surgical prophylaxis, the relationship between intraoperative antibiotic concentrations and postoperative infection and the concentrations required for effective prophylaxis have not been established. A pharmacodynamic analysis was conducted using data from a previous prospective, randomized, double-blind clinical study which compared two dosage regimens of gentamicin plus metronidazole for prophylaxis in connection with elective colorectal surgery. Univariate and multivariate analyses of risk factors for postoperative wound infection were conducted, and the relationship between intraoperative gentamicin concentrations and surgical outcome was characterized. The gentamicin concentration at the time of surgical closure was one of the strongest independent risk factors for infection (P = 0.02), along with the presence of diabetes mellitus (P = 0.02), stoma (P = 0.04), and advanced age (P = 0.05). Gentamicin concentrations at closure of less than 0.5 mg/liter were associated with an infection rate of 80% (representing 8 of 10 patients with concentrations below that level) (P = 0.003). Receiver operating characteristic curve analysis identified a critical closure concentration of 1.6 mg/liter for effective surgical prophylaxis (P = 0.002; sensitivity, 70.8%; specificity, 65.9%). This study provides new and important information on antibiotic pharmacodynamics in surgical prophylaxis. It demonstrates the critical effect of the antibiotic concentration at closure on wound infection and suggests a significant association between the concentration and other well-established risk factors, like the timing of preoperative antibiotic administration and surgery duration.

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The diffuse distribution of H-pylori in the stomach contributes partly to hyperammonaemia in patients with liver cirrhosis, and the eradication of H pylori is effective in patients with hyperammonaemia with diffuse H pylori infection in the stomach.

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The aim of this study was to determine the appropriateness of the recent recommendations for managing Helicobacter pylori infection in children in a university hospital in Southern Europe. Antimicrobial resistance and response to eradication therapy were also determined.

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We developed a microarray hybridization-based method, 'comparative genome sequencing' (CGS), to find mutations in bacterial genomes and used it to study metronidazole resistance in H. pylori. CGS identified mutations in several genes, most likely affecting metronidazole activation, and produced no false positives in analysis of three megabases. We conclude that CGS identifies mutations in bacterial genomes efficiently, should enrich understanding of systems biology and genome evolution, and help track pathogens during outbreaks.

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This study utilized linked maternal, infant, and child records for 134,596 Medicaid-insured singleton births in South Carolina from 1996 through 2002. Data were obtained from Medicaid billing records, birth certificates, and administrative data from the South Carolina Department of Education (DOE) and the Department of Disabilities and Special Needs (DDSN). Pregnancies during which women were diagnosed with urinary tract infection, chlamydia, gonorrhea, or vulvovaginal candidiasis were excluded, as were children diagnosed with a known cause of mental retardation. Odds of diagnosed ID in children were modeled using population averaged generalized estimating equation models.

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The <80 % Helicobacter pylori eradication rate with sequential therapy is unsatisfactory. Modified bismuth quadruple therapy, replacing metronidazole with amoxicillin, could be promising because H. pylori resistance to tetracycline or to amoxicillin is relatively low. A 14-day modified bismuth quadruple protocol as first-line H. pylori treatment was compared with 10-day sequential therapy.

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pseudomembranous colitis metronidazole dose 2017-04-04

Twenty pulpally involved non-vital carious human primary mandibular second molars with furcal abscess were randomly allocated into two groups to evaluate the efficacy of metronidazole gel (3% w/v) and metronidazole solution (0.5% w/v) against E. faecalis. Subjects in the first experimental group were subjected to treatment with metronidazole gel (3% w/v) and subjects in the second experimental group were treated with metronidazole solution (0. Floxin Antibiotic Alcohol 5% w/v). Two microbial samples (pre-operative and post-operative samples) were obtained from the root canals of each subject from both the groups; sub cultured and efficacy of both the groups were evaluated.

does metronidazole gel cure bv 2017-04-27

One hundred and twenty-two patients (mean age 12.36+/-3.06 years) were entered into the study. Only 100 patients completed the study (50 patients in each regimen group). The eradication rates by triple therapy were 92% and 75.5% for the "per-protocol Norbactin Medicine " and "intention-to-treat" approaches, respectively. In the quadruple regimen group, the eradication rates were 84% by the per-protocol approach and 68.8% in the intention-to-treat approach. Symptom responses to therapy were reported in all patients with successful eradication (88% of all patients).

metronidazole 375 mg 2016-04-16

Giardia lamblia is a microaerophilic human gastrointestinal parasite and considered as an early-diverged eukaryote. In vitro oxidative stress generation plays a significant role in cell cycle progression and cell death of this parasite. In the present study hydrogen peroxide, metronidazole, and a modified growth medium without cysteine and ascorbic acid have been chosen as oxidative stress-inducing agents. Cell cycle progression has been found to be regulated by different types of oxidative stresses. Apoptosis is not an established pathway in Giardia, which is devoid of ideal mitochondria, but in the present investigation, apoptosis-like programmed cell death has been found by the experiments like AnnexinV-FITC assay, DNA fragmentation pattern, etc. On the contrary, Caspase-9 assay, which confirms the caspase-mediated Augmentin 875 Mg Oral Tablet apoptotic pathway, has been found to be negative in all the stress conditions. Protease inhibitor assay confirmed that, even in absence of any proteases, programmed cell death does occur in this primitive eukaryote. All these results signify a novel pathway of programmed suicidal death in Giardia lamblia under oxidative stress. This is the first demonstration of protease-independent programmed cell death regulation in Giardia exclusive for its own specialties.

metronidazole treat yeast infection 2017-06-01

Treatment of manifestations: Critically ill individuals are stabilized by restoring volume status and acid-base balance; reducing or eliminating protein intake; providing increased calories via high glucose-containing fluids and insulin to arrest catabolism; and monitoring serum electrolytes and ammonia, venous or arterial blood gases, and urine output. Management includes a high-calorie diet low in propiogenic amino acid precursors; hydroxocobalamin intramuscular injections; carnitine supplementation; antibiotics such as neomycin or metronidazole to reduce propionate production from gut flora; gastrostomy tube placement as needed; and aggressive treatment of infections. Other therapies used in a limited number of patients include N-carbamylglutamate for the treatment of acute hyperammonemic episodes; liver, kidney, or combined liver and kidney transplantation; and antioxidants for the treatment Cefixime Ofloxacin Combination Dose of optic nerve atrophy. Prevention of primary manifestations: In some cases, newborn screening allows for presymptomatic detection of affected newborns and early treatment. Agents/circumstances to avoid: Fasting and increased dietary protein. Other: Medic Alert(®) bracelets and up-to-date, easily accessed, detailed emergency treatment protocols facilitate care.

metronidazole side effects gel 2015-06-30

Treatment with broad-spectrum antibiotics Keflex Acne Medication is the primary choice of treatment of Lemierre syndrome. Surgery is indicated in case of abscess formation.

dosage metronidazole 2015-06-12

Most gram-negative bacilli except Fusobacterium spp. Septra Pediatric Suspension Dosage were resistant to penicillin. Piperacillin/tazobactam, metronidazole, chloramphenicol, meropenem and amoxicillin/clavulanic acid were very active against all groups, but only 86% of Bacteroides fragilis group strains were susceptible to the latter. Cefoxitin, cefotetan and clindamycin were less active. In particular, only 62%, 52% and 48% of B. fragilis group strains were susceptible, respectively. Clindamycin shows a continuing decrease in activity, as 83% were still susceptible in 1987 and 66% in 1993-94. Anti-anaerobic activity of the new antibiotics is interesting, with MIC50 and MIC90 of 1 and >32 mg/L for moxifloxacin, 2 and 4 mg/L for linezolid and 0.5 and 8 mg/L for tigecycline.

metronidazole gel and alcohol how long after 2015-02-04

Within the limits of the present study, it was concluded that (i) OS improved the outcome of treatment in comparison with CNS Bactrim Ds Side Effects Reviews and (ii) ERL seemed to be more suitable to promote re-osseointegration than PCM and VUS.

metronidazole 750 mg side effects 2017-01-20

The most commonly identified pathogen was Pseudomonas aeruginosa (45.1%), followed by Staphylococcus aureus (9%), anaerobes (6.3%), beta haemolytic Streptococcus group G (2.8%), beta haemolytic Streptococcus group A (1.4%), Streptococcus pneumoniae (0.7%), methicillin resistant S. aureus (0.7%), Candida species (9.7%), Aspergillus species (4.2%) and Absidia corymbifera (0.7%). One hundred percent resistance of Pseudomonas isolates to neomycin, chloramphenicol, trimethoprim and amoxicillin was observed while most were sensitive to ciprofloxacin (100%), polymixin B (100%) and gentamicin (98.5%). S. aureus isolates were sensitive to gentamicin and flucloxacillin (100%). 92.3% were sensitive to neomycin and chloramphenicol. Resistance to penicillin and amoxicillin is observed. All isolates anaerobes were sensitive to metronidazole.

metronidazole gel cause yeast infections 2017-03-25

We present the case of a young man with a solitary abscess at the pons, without other systemic infections. The patient was treated by means of microsurgical drainage and antibiotic therapy for three weeks. His postoperative recovery was good.