Antimicrobials
Metronidazole

Metronidazole

Low
Excellent

Spectrum of Activity

Dosing

General Information

  • Increased risk for peripheral/optic neuropathy with prolonged therapy and cumulative doses >42g
  • Alternative therapies should be considered

Suspected or confirmed anaerobic infections including:

  •  Intra-abdominal
  •  Biliary
  •  Central nervous system
  •  Fulminant Clostridium difficile

Treatment of:

  •  Trichomoniasis
  •  Giardia
  •  Intestinal amebiasis

NOT Recommended for Aspiration Pneumonia UNLESS:

  • Suspected or confirmed presence of empyema or abscess

GI symptoms common - Especially nausea/vomiting and metallic taste

Peripheral/optic neuropathy - Cumulative dose related

Disulfiram-like reaction (severe vomiting)

Rare neurotoxicity including aseptic meningitis and encephalopathy

Ethanol - Disulfiram-like reaction

Increases levels of:

  •  Cyclosporine
  •  Lithium
  •  Warfarin
  •  Phenobarbital
  •  Phenytoin

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

Antimicrobial class: Nitroimidazole

Pregnancy category: B. If administered during breastfeeding, breast milk should be discarded during therapy

Average serum half life: 10 hours

Urine penetration: Poor

Lung penetration: Therapeutic

CSF penetration: Therapeutic

Biliary penetration: Therapeutic