Antimicrobials
Metronidazole

Metronidazole

None
Excellent
IV-$3/d PO-$1/d

Spectrum of Activity

General Information

  • Suspected or confirmed anaerobic infections including intra-abdominal, biliary, central nervous system
  • Clostridium difficile, Giardia and gynecological infections
  • Also used in Crohn's disease and bacterial vaginosis.

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

  • GI symptoms common- especially nausea and vomiting and metallic taste
  • Peripheral and or optic neuropathy with extended therapy
  • Disulfiram-like reaction (severe vomiting)
  • Rare neurotoxicity including aseptic meningitis and encephalopathy

Disulfiram reaction wtih alcohol or alcohol-containing medications/products.

Antimicrobial class: Nitroimidazole

Average serum half life:

  • Neonates <7 days: (prolonged with lower GA) 24.8-75.3 hours.
  • Neonates ≥7 days: ~22.5 hours
  • Children and adolescents: 6-10 hours.
  • Adults: 8 hours

Route of Elimination:

  • Urine (unchanged drug and metabolites: 60-80%; ~20% of total as unchanged drug)
  • Feces (6-15%)