Antimicrobials
Metronidazole

Metronidazole

Low
Excellent
IV:$ PO:$

Spectrum of Activity

General Information

Suspected or confirmed anaerobic infections including intra-abdominal, biliary, central nervous system, Clostridium difficile, Giardia, bacterial vaginosis, and pelvic infections.

Laboratory Consider baseline LFTs

Clinical

  • GI effects
  • Avoid alcohol
  • With prolonged therapy (>6wks) or if symptoms develop assess for peripheral/optic neuropathy
  • Nausea
  • Diarrhea
  • Disulfiram-like reactions with alcohol
  • Metallic taste
  • Reversible neutropenia

Ethanol- disulfiram-like reaction

Increases levels of cyclosporine, lithium, warfarin, and phenobarbital and phenytoin

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

Antimicrobial class: Nitroimidazole

Pregnancy category: B

Average serum half life: 10 hours

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Poor