Metronidazole topical

Gordnere/to vaginalis oni metronidazole topical clindamycin or metronidazole, or oral... 

In erythrosis 15% to 25% to 30% salicylic acid peeling should be performed at 3-week intervals for a total of three to four peelings (Fig. 17.14a, b). Suggested topical treatment between peeling includes 0,75% metronidazole cream once a day or 1-2% salicylic acid cream once a day and sunblock creams... 

In papulo-pustular rosacea 25-30% salicylic acid peeling is utilized in association with systemic treatment with metronidazole or antibiotics and topical treatment as for erythrosis (Figs. 1715,1716 and i/.i/)-... 

Topical therapy with 0.75 metronidazole or 1-2% salicylic acid... 

Elewski B, Fleischer AB, Pariser DM (2003) A comparison of 15% topical azelaic acid gel and 0.75% metronidazole gel in the topical treatment of papu-lopustular facial rosacea results of a randomized trial. Arch Dermatol 139 1444-1450... 

Dahl MV, Jarratt M, Kaplan D, Tuley MR, Baker MD (2001) Once-daily topical metronidazole cream formulations in the treatment of the papules and pustules of rosacea. J Am Acad Dermatol 45 723-730... 

The broad antibacterial activity of rifaximin as well as its topical action make this antibiotic suitable for intrapocket administration in periodontal disease. As a matter of fact, local application of rifaximin compares well with tetracyclines and metronidazole in other extra-GI diseases, i.e. skin infections and BY, respectively (see above). On the other hand, rifampicin (rifampin), another rifamy-cin derivative, has been successfully used in the treatment... 

Topical agents with minimal pregnancy risk include bacitracin, benzoyl peroxide, ciclopirox, clindamycin, erythromycin, metronidazole, mupi-rocin, permethrin, and terbinafine. 

Finlay, I.G., Bowszyc, J., Ramlau, C. and Gwiezdzinski,Z. (1996) The effect of topical 0.75% metronidazole gel on malodorous cutaneous ulcers. J. Pain Symptom Manag. 11, 158-162. 

Metronidazole also is available for topical and intravaginal use and also is used orally as an amebicide. 

Metronidazole also is indicated for amebiasis and trichomoniasis, intravaginally for bacterial vaginosis, and topically for acne rosacea. 

Echinacea (Echinacea purpurea) Uses immune system stimulant prevention/Rx of colds, flu as supportive th apy for colds chronic infxns of the resp tract lower urinary tract Action Stimulates phagocytosis cytokine production T resp cellular activity topically exerts anesthetic, antimicrobial, anti-inflammatory effects Efficacy Not established may X severity duration of URI Available forms Caps w/ powdered herb equivalent to 300-500 mg, PO, tid pressed juice 6-9 mL, PO, once/d tine 2-4 mL, PO, tid (1 5 dilution) tea 2 tsp (4 g) of powdered herb in 1 cup of boiling water Noles/SE Fever, taste p -version, urticaria, angioedema Contra w/ autoimmune Dz, collagen Dz, progressive systemic Dz (TB, MS, collagen-vascular disorders), HIV, leukemia, may interfere w/ immunosuppressive therapy Interactions t Risk of disulfiram-like reaction W/ disulfiram, metronidazole T risk of exacerbation of HIV or AIDS W/ chinacea amprenavir, other protease inhibitors X effects OF azathioprine, basiliximab, corticosteroids, cyclosporine, daclizumab, econazole vag cream, muromonab-CD3, mycophenolate, prednisone, tacrolimus EMS Possible immunosuppression... 

Metronidazole is effective in the treatment of acne rosacea although for this indication its mechanism of action is not clearly understood. Long-term topical use for this indication is not recommended. This advice is founded on experiments in animals showing a carcinogenic effect by oral administration of metronidazole. There is inadequate evidence of the safety of metronidazole in human pregnancy. Metronidazole is classified in Lactation Risk Category L3 (moderately safe). 

Another topical antibiotic, metronidazole, is effective in the treatment of acne rosacea. Metronidazole is a synthetic nitroimidazole derivative that reduces inflammation by an unknown mechanism. Other selected topical antibiotics are listed in Table 41.2. 

The patient using topical metronidazole should avoid drug contact with eyes... 

Clindamycin is active against Propionibacterium acnes. Erythromycin alone and in combination with benzoyl peroxide is used in the treatment of acne vulgaris. Topical metronidazole is effective in the treatment of acne rosacea. 

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. 

Several systemic antibiotics that have traditionally been used in the treatment of acnevulgaris have been shown to be effective when applied topically. Currently, four antibiotics are so utilized clindamycin phosphate, erythromycin base, metronidazole, and sulfacetamide. The effectiveness of topical therapy is less than that achieved by systemic administration of the same antibiotic. Therefore, topical therapy is generally suitable only in mild to moderate cases of inflammatory acne. 

Topical metronidazole is effective in the treatment of rosacea. The mechanism of action is unknown, but it may relate to the inhibitory effects of metronidazole on Demodex brevis alternately, the drug may act as an anti-inflammatory agent by direct effect on neutrophil cellular function. Oral metronidazole has been shown to be a carcinogen in susceptible rodent species, and topical use during pregnancy and by nursing mothers and children is therefore not recommended. 

Metronidazole is used for treatment of bovine trichomoniasis by topical application or intravenous injection of 75 mg/kg bw. It is also used for treatment of swine dysentery at a dosage of 25 mg/kg bw/day for 4 days, whereas, for eradication of the disease in herds, treatment for 7 days followed, after 3-4 weeks, by a second treatment for 5 days in indicated. Metronidazole is a genotoxic carcinogen in animals. 

Metronidazole is the treatment of choice. A single dose of 2 g is effective. Metronidazole-resistant organisms may lead to treatment failures. Tinidazole may be effective against some of these infections, but it is not available in the USA. Such cases may require repeat courses of metronidazole at higher doses than normally recommended—or topical therapy. 

P. Wotton, B. Mollgaard, J. Hadgraft, and A. Hoelgaard, Vehicle effect on topical drug delivery. III. Effect of azon on the cutaneous permeation of metronidazole and propylene glycol, Int. J. Pharm. 24 19-26 (1985). 

METRONIDAZOLE BARBITURATES 1 levels of these drugs, with risk of therapeutic failure Induction of hepatic metabolism. Unlikely with topical metronidazole 1. Avoid co-administration of telithromycin for up to 2 weeks after stopping phenobarbital... 

Topical preparations for the treatment of rosacea include metronidazole 0.75% or 1% cream, 0.75% gel, or lotion. None of these preparations is FDA-approved for ophthalmic use, but they have been beneficial fiar some patients. 

In most instances patients demonstrate significant improvement of clinical symptomatology and physical signs in the first 2 to 3 weeks. Many patients, however, require chronic therapy and demonstrate exacerbations of the disease during its course. Metronidazole (MetroGel) is a topical gel developed to treat the skin of the facial area in patients with chronic disease and thus reduce the reliance on oral antimicrobial agents. It is applied twice daily. Although not yet an approved use, metronidazole gel applied to the eyelids was found to be an effective treatment of ocular rosacea. 

Barnhorst DA Jr, Foster JA, Chern KC, Meisler DM. The efficacy of topical metronidazole in the treatment of ocular rosacea. Ophthalmology 1996 103 1880-1883. 

Dose. Established anaerobic infection is treated with metronidazole by mouth 400 mg 8-hourly by rectum 1 g 8-hourly for 3 days followed by 1 g 12-hourly or by i.v. infusion 500 mg 8-hourly. A topical gel preparation is useful for reducing the odour associated with anaerobic infection of fungating tumours. 

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