Metronidazole

C difficile risk
Low
Oral Bioavailability
Excellent
Cost
IV $7/d PO $0.30/d

Dosing

500 mg PO/IV q12h

7.5 mg/kg IV q6 - 8h (round to the nearest 250mg; minimum dose 500mg)

500 mg IV/PO q8h

General Information

Suspected or confirmed anaerobic infections including:

  • Intra-abdominal

  • Central nervous system

  • Clostridium difficile

  • Giardia

  • Pelvic infections

Also used in:

  • Bacterial vaginosis

  • Hepatic encephalopathy

Assess for peripheral/optic neuropathy with prolonged therapy (>6wks) or if symptoms develop.

  • 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

  • Phenobarbital

  • Phenytoin

Antimicrobial class: Nitroimidazole

Pregnancy category: B

Average serum half life: 10 hours

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Poor

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