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The Journal of Antimicrobial... Sep 1979
Review
Topics: Anaerobiosis; Bacteria; DNA, Bacterial; Female; Humans; Metronidazole; Oxidation-Reduction; Trichomonas vaginalis
PubMed: 387703
DOI: 10.1093/jac/5.5.499 -
Gastroenterologia Y Hepatologia 2017Blastocystis hominis (B. hominis) is a protozoan commonly found in the gastrointestinal tract. There are doubts about its clinical significance. Metronidazole (MTZ) is... (Review)
Review
INTRODUCTION
Blastocystis hominis (B. hominis) is a protozoan commonly found in the gastrointestinal tract. There are doubts about its clinical significance. Metronidazole (MTZ) is the recommended first-line treatment.
MATERIALS AND METHODS
A retrospective review was carried out between 2011 and 2012. A total of 151 samples were randomly selected from 383 samples positive for B. hominis. Inclusion criteria were: suggestive symptoms, treatment indication and microbiological follow-up. A systematic review was performed of all studies that evaluated the effect of MTZ on B. hominis infection.
RESULTS
Forty-six patients met the inclusion criteria (64% women; age, 44.2±2 years). MTZ was used in 39 patients, 31 of whom obtained a clinical response (79.5%) but only 15 a microbiological response (48.4%). No dose-effect relationship was observed. Twenty patients with no initial microbiological response received a second round of treatment (MTZ, cotrimoxazole, paramomycin, others), with a microbiological response in 70%. Overall, B. hominis was cured in 72% (95% CI: 57%-83%). Of 54 treatments associated with a clinical response, a microbiological response occurred in 31 (57%), while in the remaining 12 with no clinical response, microbiological cure was observed in only 2 (17%) (P=.022). The eradication rate in the systematic review varied between 0% and 100%.
CONCLUSIONS
There seems to be a relationship between the clinical and microbiological response to B. hominis treatment. The microbiological response to MTZ treatment is insufficient in our geographical setting. The systematic review shows that the response to MTZ is very variable.
Topics: Aged; Antiprotozoal Agents; Blastocystis Infections; Blastocystis hominis; Diarrhea; Drug Resistance; Drug Substitution; Dyspepsia; Feces; Female; Humans; Male; Metronidazole; Middle Aged; Retrospective Studies; Sampling Studies; Treatment Outcome
PubMed: 28279442
DOI: 10.1016/j.gastrohep.2016.11.003 -
Journal of Clinical Gastroenterology Oct 1988The efficacy of metronidazole in the treatment of Crohn's disease remains unproven. It has not been superior to a placebo in three small studies. Uncontrolled reports... (Clinical Trial)
Clinical Trial Review
The efficacy of metronidazole in the treatment of Crohn's disease remains unproven. It has not been superior to a placebo in three small studies. Uncontrolled reports suggest it may be of benefit in selected patients who have not responded to previous medical or surgical therapy. Metronidazole therapy can lead to complete healing of perineal fistulas. Persistent concerns over side-effects, carcinogenicity, and bacterial resistance suggest that drug should be prescribed with caution for long-term use.
Topics: Clinical Trials as Topic; Crohn Disease; Humans; Metronidazole
PubMed: 3053871
DOI: 10.1097/00004836-198810000-00002 -
American Journal of Obstetrics and... Apr 1983
Review
Topics: Abnormalities, Drug-Induced; Animals; Chemical Phenomena; Chemistry; Drug Resistance, Microbial; Female; Genital Diseases, Female; Humans; Kinetics; Lactation; Maternal-Fetal Exchange; Metronidazole; Mutation; Parasitic Diseases; Pregnancy; Premedication; Vaginitis
PubMed: 6340508
DOI: 10.1016/0002-9378(83)90693-2 -
Journal of Pharmaceutical Sciences Nov 1969
Topics: Colorimetry; Metronidazole; Spectrophotometry; Suppositories; Tablets
PubMed: 5349759
DOI: 10.1002/jps.2600581124 -
The British Journal of Psychiatry : the... Jul 1968
Topics: Adult; Alcoholism; Humans; Male; Metronidazole; Middle Aged
PubMed: 5662940
DOI: 10.1192/bjp.114.512.859 -
Infection Control : IC Feb 1987
Topics: Metronidazole
PubMed: 3644802
DOI: 10.1017/s0195941700067059 -
The New Zealand Medical Journal Apr 2018To evaluate an antimicrobial stewardship (AMS) initiative to change hospital prescribing practice for metronidazole.
AIMS
To evaluate an antimicrobial stewardship (AMS) initiative to change hospital prescribing practice for metronidazole.
METHODS
In October 2015, the Canterbury District Health Board (CDHB) AMS committee changed advice for metronidazole to promote two times daily dosing for most indications, prioritisation of the oral route and avoidance of double anaerobic cover. Adoption of the initiative was facilitated via change in prescribing guidelines, education and ongoing pharmacy support. Usage and expenditure on metronidazole for adult inpatients were compared for the five years pre- and two years post-change. Other district health boards (DHBs) were surveyed to determine their dosing recommendation for metronidazole IV.
RESULTS
Mean annual metronidazole IV use, as defined daily doses per 1,000 occupied bed days, decreased by 43% post-initiative. Use of non-IV (oral or rectal) formulations increased by 104%. Total savings associated with the initiative were approximately $33,400 in drug costs plus $78,200 per annum in IV giving sets and post-dose flushes. Twelve of 20 (60%) DHBs (including CDHB) endorse twice daily IV dosing.
CONCLUSIONS
In addition to financial savings, reduction in IV doses has potential benefits, including avoidance of IV catheter-associated complications such as bloodstream infections. Approaches to metronidazole dosing vary across DHBs and could benefit from national coordination.
Topics: Antimicrobial Stewardship; Drug Costs; Drug Utilization; Hospitals, Public; Humans; Metronidazole; Practice Guidelines as Topic
PubMed: 29649197
DOI: No ID Found -
American Family Physician Jul 1981
Topics: Administration, Oral; Animals; Bacterial Infections; Female; Humans; Injections, Intravenous; Liver; Metronidazole; Protozoan Infections; Tissue Distribution; Vaginitis
PubMed: 7258064
DOI: No ID Found -
The Australian Nurses' Journal. Royal... Jun 1981
Topics: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Metronidazole; Pregnancy
PubMed: 6912042
DOI: No ID Found