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Author: Admin | 2025-04-28
Dental parameters and increased beneficial bacteria Silva-Senem 2013. In addition, clinical experience suggests the utility of metronidazole (with amoxicillin) for the treatment of severe periodontitis Wilder 2019.Pouchitis (post ileal pouch-anal anastomosis)aIn a systematic review of available clinical trials evaluating the treatment and prevention of pouchitis after ileal pouch-anal anastomosis for chronic ulcerative colitis, metronidazole was found to be less effective than ciprofloxacin but as effective as budesonide enemas for inducing remission in acute pouchitis. Metronidazole is considered an effective alternative treatment for this condition Holubar 2010.Data from a noncomparative cohort study suggest that metronidazole, in combination with ciprofloxacin, may be beneficial for the treatment of patients with chronic pouchitis Mimura 2002.Surgical prophylaxis, colorectal surgery (oral metronidazole)yesBased on the American Society of Health-System Pharmacists, IDSA, Surgical Infection Society, and SHEA guidelines for antimicrobial prophylaxis in surgery, oral metronidazole, in combination with additional oral antibiotics and in conjunction with mechanical bowel preparation, is effective and recommended for colorectal surgery prophylaxis Bratzler 2013.Surgical prophylaxis, uterine evacuation (induced abortion or pregnancy loss)yesBased on the American College of Obstetricians and Gynecologists guidelines for prevention of infection after gynecologic procedures, metronidazole is effective and recommended as an alternative agent for antimicrobial prophylaxis for uterine evacuation procedures in case of induced abortion or pregnancy loss.TetanusbyesData from an open-label clinical trial in patients with moderate tetanus treated with either metronidazole or intramuscular procaine penicillin suggest that metronidazole may be beneficial and possibly superior to the use of penicillin for the treatment of this condition Ahmadsyah 1985. ContraindicationsHypersensitivity to metronidazole, nitroimidazole derivatives, or any component of the formulation; pregnant patients (first trimester) with trichomoniasis; use of disulfiram within the past 2 weeks; use of alcohol or propylene glycol-containing products during therapy or within 3 days of therapy discontinuationCanadian labeling: Additional contraindications (not in the US labeling): Active neurological disorders; history of blood dyscrasia; hypothyroidism; hypoadrenalism Dosage and AdministrationDosing: AdultAmebiasis, intestinal (acute dysentery) or extraintestinal (liver abscess): Oral: 500 to 750 mg every 8 hours for 7 to 10 days followed by an intraluminal agent (eg, paromomycin) (Drugs for Parasitic Infections 2013; Leder 2018a; Leder 2018b).Bacterial vaginosis: Oral: 500 mg
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