Metronidazole bacterial infections

The answer is d. (Hardman, p 989.) Both trimethoprim-sulfamethoxazole and pentamidine are effective in pneumonia caused by E carinii. This protozoal disease usually occurs in immunodeficient patients, such as those with AIDS. Nifurtimox is effective in trypanosomiasis and metronidazole in amebiasis and leishmaniasis, as well as in anaerobic bacterial infections. Penicillins are not considered drugs of choice for this particular disease state. 

Anaerobic bacterial infections In the treatment of most serious anaerobic infections, metronidazole is usually administered IV initially. 

Metronidazole is the drug of choice in Europe for anaerobic bacterial infections concern about possible carcinogenicity has led to some caution in its use in the United States. Recently it has been found to be effective in treating D. medinensis (Guinea worm) infections and Helicobacter pylori... 

As indicated in Chapter 33, metronidazole has bactericidal effects and is used in certain gram-negative bacterial infections. This drug may be administered orally or intravenously. Other agents have also been developed that are structurally and functionally similar to metronidazole. Tinidazole (Tindamax), for example, can be used in cases where metronidazole is not tolerated or is ineffective.24... 

Metronidazole (vag) Antifungal Certain types of bacterial infections in the vagina Metrogel 0.75,1.0... 

The use of metronidazole against infections with anerobic bacteria has increased over the years, and with this indication the use of metronidazole in combination with many other drugs used by patients with conditions likely to develop secondary anaerobic bacterial infections. With increased use there is also a widespread and increasing incidence of resistance of various strains of bacteria. The use of metronidazole as an added medication merely to make assurance double sure is to be discouraged. It is to be especially discouraged in immunocompromised patients, because of the risk of emergence of resistant bacterial strains. With increased use there is also an increased number of reports of some more unusual adverse effects. Overall, metronidazole can still be considered safe, if used in generally recommended doses. 

To treat mixed bacterial infections. For example, it is rational to combine gentamicin plus a beta-lactam plus metronidazole for cases of equine pleuropneumonia, which predictably involve mixed infections of Strq). zooepidemicus, Gram-negative enteric bacteria and anaerobes. 

Metronidazole has been shown to be of great value in the management of anaerobic bacterial infections [20,27,75,76]. The role of this drug in the prophylaxis and treatment of various anaerobic bacterial infections, which may develop following appendectomy, elective colonic surgery, colo-rectal surgery and hysterectomy [20,77,78]. Mebendazole is equally useful in cases of endocarditis, osteomyelitis, lung abscess, empyema, peritonitis, septicemia and pelvic infections [79]. 

Metronidazole was initially introduced for the treatment of vaginal infections caused by Trichomonas vaginalis but has since been shown to be effective for treatment of amebiasis, giardiasis, and anaerobic bacterial infections, including Clostridium difficile. 

Cefuroxime is indicated to treat infections of bacterial origin such as urinary tract infections, otitis media and upper respiratory tract infections. Bacterial vaginosis is likely to be treated with metronidazole and clindamycin. 

Metronidazole is indicated for treatment of anaerobic or mixed intra-abdominal infections, vaginitis (trichomonas infection, bacterial vaginosis), C difficile colitis, and brain abscess. The typical dosage is 500 mg three times daily orally or intravenously (30 mg/kg/d). Vaginitis may respond to a single 2-g dose. A vaginal gel is available for topical use. 

Metronidazole is used as an antibiotic for certain bacterial and parasitic infections. 

Pregnant women with a history of preterm delivery should undergo screening for bacterial vaginosis at the first prenatal visit. If the infection is present, the recommended regimen is metronidazole 250 mg three times a day for 7 days or clindamycin 300 mg twice a day for 7 days. ... 

Metronidazole (Flagyl) is used for both bacterial (commonly for dental infections) and some protozoan infections, such as amoebic dysentery. Benzimidazoles, such as mebendazole (Pripsen), are an important group of anthelmintics. The most common anti-fungal agents are triazoles such as fluconazole (Diflucan). 

Antibiotics can be used as either (1) adjunctive treatment along with other medications for active IBD (2) treatment for a specific complication of Crohn s disease or (3) prophylaxis for recurrence in postoperative Crohn s disease. Metronidazole, ciprofloxacin, and clarithromycin are the antibiotics used most frequently. They are more beneficial in Crohn s disease involving the colon than in disease restricted to the Ueum. Specific Crohn s disease-related complications that may benefit from antibiotic therapy include intra-abdominal abscess and inflammatory masses, perianal disease (including fistulas and perirectal abscesses), small bowel bacterial overgrowth secondary to partial small bowel obstruction, secondary infections with organisms such as Clostridium difficile, and postoperative complications. Metronidazole may be particularly effective for the treatment of perianal disease. Postoperatively, a 3-month course of metronidazole (20 mg/kg/day) can prolong the time to both endoscopic and clinical recurrence. 

Although many infections with gram-positive cocci respond to clindamycin, the high incidence of diarrhea and the occurrence of pseudomembranous colitis limit its use to infections where it is clearly superior to other agents. Clindamycin is particularly valuable for anaerobic infections, especially those due to B. fragiUs. Clindamycin is not predictably useful for the treatment of bacterial brain abscesses metronidazole, in combination with penicillin or a third-generation cephalosporin, is preferred. 

Anukam KC, Osazuwa E, Osemene Gl, Ehigiagbe F, Bruce AW, Reid G. Clinical study comparing probiotic Lactobacillus GR-1 and RC-14 with metronidazole vaginal gel to treat symptomatic bacterial vaginosis. Microbes and Infection. 2006 8(12) 2772—2776. 

Amoebiasis, due to infection with Entamoeba histolytica, is conveyed between humans by its cysts which are 10 microns in diameter. They survive well outside the body and are ingested in water and uncooked food. In the colon, the larger vegetative forms (trophozoites) emerge and cause chronic diarrhoea and, often, ulceration of the bowel wall. Unlike bacterial dysentery, this disease is seldom self-limiting without proper medication. Abscesses in the liver form a common complication. A ready cure can be effected with metronidazole (Section 6.3.3). 

Metronidazole is an antimicrobial agent used for treating anaerobic bacterial and protozoal infections. It is administered in tablet form or as a suppository, but has low aqueous solubility, rendering it unsuitable for parenteral administration in life-threatening cases. It is weakly basic with a pKa of 2.5 (the electron-withdrawing effect of the aromatic nitro-group renders the lone pair on the imidazole-nitrogen much less available for proton acceptance compared with imsubstituted imidazoles), which means that water soluble chloride salts are not particularly stable for parenteral administration, readily... 

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