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 gynecoogical infections
  • Also used in Crohn's disease and bacterial vaginosis.

With prolonged therapy (>6wks) 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.

Concentration: 50 mg/mL (compounded)

Taste: less palatable, unpleasant taste

Not all strengths of oral liquids are listed nor are available on IWK formulary

250 mg tablet

Tablets and capsules are preferred especially over an unpleasant tasting liquid.

Not all strengths of oral tablets/capsules are listed and they are not all available on the IWK formulary.

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%)