Management of a 42 year old female patient diagnosed with trichomoniasis is described. She failed to respond to recommended oral and high dose oral and topical metronidazole. Various options used in previously reported cases of metronidazole resistant trichomoniasis also failed to cure her condition. MIC showed the organism to be resistant to metronidazole. Cure was achieved with the use of top...

It has been suggested that the measurement of metronidazole clearance is a sensitive method for evaluating liver function. The aim of this study was to evaluate the usefulness of plasma hydroxy-metronidazole/metronidazole ratios as indicators of dynamic liver function to detect changes resulting from the various forms of chronic hepatitis C virus (HCV) infection. A total of 139 individuals were...

The trend of increasing prevalence of antibiotic resistance among Helicobacter pylori strains has been suggested as a cause of the failure of treatment of H. pylori infections. In this study, 120 of 211 antral biopsy specimens from patients with dyspeptic symptoms were found to harbor H. pylori. The isolates from the 120 specimens were tested by the agar dilution method, and 38 (31.7%) were fou...

Bacterial vaginosis (BV) is the commonest cause of vaginal discharge in women of childbearing age. Oral metronidazole has long been established as an effective therapy in the treatment of BV. However, adverse effects due to metronidazole are frequent and this may lead to problems with adherence to a 7-day course of treatment and subsequently result in treatment failure. Oral tinidazole has been...

Ten severely ill patients with life threatening sepsis received metronidazole as suppositories and blood concentrations of the drug were measured twice daily over five days. Therapeutic blood concentrations of metronidazole were maintained at all times in all patients. Rectal administration of metronidazole is accepted as effective prophylaxis against infection associated with surgery and as tr...

Nifuratel (Magmilor) was compared with metronidazole (Flagyl) in the treatment of trichomonal vaginitis by a randomized double-blind trial. Only 18 out of 47 patients (38%) treated with nifuratel were found to be cured, whereas 42 out of 49 patients (85%) treated with metronidazole were cured. Severe reactions, necessitating withdrawal of treatment, occurred in three patients treated with nifur...

A new substituted nitroimidazole, nitrimidazine (Naxogin), is compared with the established drug, metronidazole (Flagyl), for the treatment of vaginal trichomoniasis in a randomized double-blind trial. Nitrimidazine cured 39 (68%) out of 57 patients and showed no undesirable effects other than nausea in one patient. Metronidazole cured 51 (89%) out of 57 patients and also caused nausea in one p...

Synergy studies were performed with metronidazole in combination with clindamycin, rifampin, nalidixic acid, ticarcillin, erythromycin, and spectinomycin against Bacteroides fragilis strains. An agar dilution technique was used with two inoculum sizes (10(6) to 10(7) or 10(3) to 10(4) colony-forming units per ml). None of the drugs showed synergy with metronidazole against greater than 50% of t...

In the 1970s an interaction between metronidazole and warfarin was described in healthy volunteers. Subsequently, there have been few reports describing the interaction during the concurrent administration of warfarin and metronidazole. A critical analysis of warfarin interactions concluded that the metronidazole-warfarin interaction is “highly probable”, with metronidazole potentiating the ant...

Metronidazole is a commonly used antibiotic with potent activity against anaerobic bacteria and protozoa. It is believed to cross bloodbrain-barrier and penetrate central nervous system easily. While metronidazole is fairly safe and well tolerated, it can rarely cause serious neurological adverse events, including peripheral neuropathy, cerebellar dysfunction, ototoxicity, seizures, visual impa...