Antimicrobials
Metronidazole

Metronidazole

Low
Complete (100%)
$2.58 (PO) $10.14 (IV)

Spectrum of Activity

Dosing

General Information

Suspected or confirmed anaerobic infections including:

  • Intra-abdominal
  • Biliary
  • Central nervous system
  • Clostridium difficile: PO used only if cannot get access to PO vancomycin or fidaxomicin. May be used IV in fulminant cases. 
  • Giardia
  • Pelvic infections

Also used in:

  •  Crohns disease
  •  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

IV Administration: Premixed 500mg bags; infuse over 30-60 min. Premixed bags are not compatible with pumps used in Community IV program

Tablets/capsules may be administered via NG route; No liquid formulation available

OPEN BENEFIT (PO): No prescribing restrictions

Antimicrobial class: Nitroimidazole

Pregnancy category: B

Average serum half life: 10 hours

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Poor