Antimicrobials
Metronidazole

Metronidazole

Low
Excellent
IV-$3/d PO-$1/d

Dosing

General Information

Suspected or confirmed anaerobic infections including intra-abdominal, biliary, central nervous system, Clostridium difficile, Giardia and pelvic infections.

Also used in Crohns disease, bacterial vaginosis, and hepatic encephalopathy

With prolonged therapy (>6wks) or if symptoms develop assess for peripheral/optic neuropathy

GI symptoms common- especially nausea/vomiting and metallic taste

Peripheral/optic neuropathy with extended therapy

Disulfiram-like reaction (severe vomiting)

Rare neurotoxicity including aseptic meningitis and encephalopathy

Ethanol- disulfiram-like reaction

Increases levels of cyclosporine, lithium, warfarin, and phenobarbital and phenytoin

Bacterial, protozoal and ameobic DNA is fragmented by reactive nitroso-imidazole radicals

Antimicrobial class: Nitroimidazole

Pregnancy category: B

Average serum half life: 10.0

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Poor