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Experimental Parasitology Nov 1997
Review
Topics: Animals; Antitrichomonal Agents; Drug Resistance; Metronidazole; Trichomonadida
PubMed: 9371098
DOI: 10.1006/expr.1997.4223 -
British Journal of Clinical Pharmacology Jul 19881. Milk and plasma metronidazole and hydroxymetronidazole concentrations were measured in 12 breast-feeding patients following multiple doses of metronidazole (400 mg...
1. Milk and plasma metronidazole and hydroxymetronidazole concentrations were measured in 12 breast-feeding patients following multiple doses of metronidazole (400 mg three times daily). All patients received metronidazole in combination with other broad spectrum antibiotics. 2. Plasma concentrations of both parent drug and metabolite were measured in seven suckling infants. Thirty-five infants were monitored for adverse reactions to maternal metronidazole therapy and two further groups of suckling infants, those whose mothers received either ampicillin alone or no drug therapy, were recruited as controls. 3. The mean milk to plasma ratio (M/P) was 0.9 for metronidazole and 0.76 for hydroxymetronidazole while the mean milk metronidazole concentrations (around Cmax) were 15.5 micrograms ml-1. The mean milk hydroxymetronidazole concentration was 5.7 micrograms ml-1. 4. Infant plasma metronidazole concentrations ranged from 1.27 micrograms ml-1 to 2.41 micrograms ml-1, and the corresponding hydroxymetronidazole concentrations from 1.1 to 2.4 micrograms ml-1. 5. There were no significant increases in adverse effects in infants which could be attributable to maternal metronidazole therapy. 6. Metronidazole was excreted in milk at concentrations which caused no serious reactions in the infants studied. The drug may therefore be administered at doses of 400 mg three times daily to mothers wishing to breast-feed their infants.
Topics: Adult; Body Weight; Female; Humans; Infant; Infant, Newborn; Male; Metronidazole; Milk, Human
PubMed: 3203060
DOI: 10.1111/j.1365-2125.1988.tb03362.x -
Der Hautarzt; Zeitschrift Fur... Jun 2016
Topics: Anti-Infective Agents; Dermatology; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Prescriptions; Drug Storage; Germany; Humans; Metronidazole; Practice Guidelines as Topic; Skin Diseases
PubMed: 27178038
DOI: 10.1007/s00105-016-3798-y -
Rehabilitation Nursing : the Official... 1992Malodorous skin lesions (primarily fungating tumors and decubitus ulcers) can be extremely resistant to efforts to control their odors. The offending bacteria appear to...
Malodorous skin lesions (primarily fungating tumors and decubitus ulcers) can be extremely resistant to efforts to control their odors. The offending bacteria appear to be anaerobes, specifically the Bacteroides species. Topical metronidazole has shown promise for odor control without the cost or side effects of a systemic drug. In various anecdotal reports, lesions in patients treated with topical metronidazole were virtually free of odor within 24 hours, and in some cases, slight improvements in wound appearance and pain also were noted. The encouraging results of these initial experiences with topical metronidazole warrant further study for its efficacy in reducing skin lesion odor.
Topics: Administration, Topical; Humans; Metronidazole; Odorants; Pressure Ulcer; Skin Neoplasms
PubMed: 1448604
DOI: 10.1002/j.2048-7940.1992.tb01558.x -
Scientific Reports Jul 2022Metronidazole in aqueous solution is sensitive to light and UV irradiation, leading to the formation of N-(2-hydroxyethyl)-5-methyl-l,2,4-oxadiazole-3-carboxamide. This...
Metronidazole in aqueous solution is sensitive to light and UV irradiation, leading to the formation of N-(2-hydroxyethyl)-5-methyl-l,2,4-oxadiazole-3-carboxamide. This is revealed here by liquid chromatography with tandem photo diode array detection and mass spectrometry (LC-PDA-MS) and further verified by comparison with the corresponding reference substance and proton nuclear magnetic resonance (H-NMR). However, in current compendial tests for related substances/organic impurities of metronidazole, the above photolytic degradant could not be detected. Thus, when photodegradation of metronidazole occurs, it could not be demonstrated. In our study, an improved LC method was developed and validated, which includes a detection at a wavelength of 230 nm and optimization of mobile phase composition thereby a better separation was obtained.
Topics: Chromatography, Liquid; Mass Spectrometry; Metronidazole; Photolysis
PubMed: 35804169
DOI: 10.1038/s41598-022-15625-5 -
Diseases of the Colon and Rectum Nov 2022Both topical and oral metronidazole have been shown to reduce pain after excisional hemorrhoidectomy. Although recent meta-analyses have demonstrated efficacy against... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Both topical and oral metronidazole have been shown to reduce pain after excisional hemorrhoidectomy. Although recent meta-analyses have demonstrated efficacy against placebo, there has been no comparison between the 2 routes.
OBJECTIVE
This study aims to investigate whether topical or oral metronidazole provides the most analgesic properties after excisional hemorrhoidectomy.
DESIGN
A prospective, double-blind, randomized controlled trial was performed.
SETTING
This trial was conducted at 2 hospitals in New Zealand between March 2019 and February 2020.
PATIENTS
Adults undergoing elective excisional hemorrhoidectomy for grade III/IV hemorrhoids were randomized.
INTERVENTIONS
Participants were randomized to receive either topical metronidazole ointment and an oral placebo versus oral metronidazole with a placebo ointment for 7 days.
MAIN OUTCOME MEASURES
The primary outcome was daily pain scores for 7 days, estimated using a generalized linear mixed model fitted with time and treatment arm and tested for interaction with time and treatment arm. Secondary outcomes included additional analgesia, return to normal activity, recovery scores, and adverse effects.
RESULTS
A total of 120 participants were included, with 60 in each group. A unimodal peak of pain was recorded with the maximum at days 3 and 4, but there was no significant difference in resting pain scores, with a mean difference at day 3 of 0.47 (-0.48, 1.42). There were no significant differences for secondary outcomes. Fourteen (11.7%) participants were readmitted, without significant difference between groups. Fifty-nine percent of participants preferred topical analgesic compared with 31% who preferred oral and 9.7% who had no preference.
LIMITATIONS
This was a pragmatic study in which we could not have stopped participants seeking other analgesics and with less than perfect complete compliance.
CONCLUSION
Postoperative oral and topical metronidazole provide similar analgesia after excisional hemorrhoidectomy. The route should depend on patient preference, with topical administration potentially benefiting from improved antimicrobial stewardship and having less effect on the gut microbiome. See Video Abstract at http:/links.lww.com/DCR/B853 .METRONIDAZOL TÓPICO VERSUS ORAL DESPUÉS DE UNA HEMORROIDECTOMÍA POR ESCISIÓN: UN ENSAYO CONTROLADO ALEATORIO DOBLE CIEGO.
ANTECEDENTES
Se ha demostrado que tanto el metronidazol tópico como el oral reducen el dolor después de una hemorroidectomía por escisión. Aunque los metaanálisis más recientes han demostrado eficacia frente al placebo, no ha habido comparación entre las dos vías.
OBJETIVO
Este estudio tiene como objetivo investigar si el metronidazol tópico u oral proporciona las propiedades más analgésicas después de una hemorroidectomía por escisión.
DISEO
Se realizó un ensayo prospectivo, controlado, aleatorio, a doble ciego.
AJUSTE
Este ensayo fue realizado en dos hospitales de Nueva Zelanda entre marzo de 2019 y febrero de 2020.
PACIENTES
Se asignaron al azar pacientes adultos sometidos a hemorroidectomía por escisión electiva por hemorroides de grado III / IV.
INTERVENCIONES
Los participantes fueron asignados al azar para recibir un ungüento de metronidazol tópico y un placebo oral versus metronidazol oral con un ungüento de placebo durante siete días.
PRINCIPALES MEDIDAS DE RESULTADO
El resultado primario fueron las puntuaciones diarias de dolor durante siete días, estimadas mediante un modelo lineal mixto generalizado ajustado tanto con el tiempo y el brazo de tratamiento y probado para la interacción con el tiempo y el brazo de tratamiento. Los resultados secundarios incluyen analgesia adicional, retorno a la actividad normal, puntuaciones de recuperación y efectos adversos.
RESULTADOS
Se incluyó un total de 120 participantes, 60 en cada grupo. Se registró un pico de dolor unimodal con el máximo en los días 3 y 4, pero no hubo diferencias significativas en las puntuaciones de dolor en reposo, con una diferencia media en el día 3 de 0,47 (-0,48, 1,42). No hubo diferencias significativas para los resultados secundarios. Catorce (11,7%) participantes fueron readmitidos, sin diferencias significativas entre los grupos. El cincuenta y nueve por ciento de los participantes prefirió el tópico, en comparación con el 31% por vía oral y el 9,7% sin preferencia.
LIMITACIONES
Este fue un estudio pragmático en el que no pudimos haber impedido que los participantes buscaran otros analgésicos, con un cumplimiento completo menos que perfecto.
CONCLUSINES
El metronidazol posoperatorio por vía oral o tópica proporciona una analgesia similar después de una hemorroidectomía por escisión. La vía debe depender de la preferencia del paciente, y la administración tópica se beneficia potencialmente por una mejor protección de los antimicrobianos y un menor efecto sobre el microbioma intestinal. Consulte Video Resumen en http://links.lww.com/DCR/B853 . (Traducción-Dr Osvaldo Gauto).
Topics: Adult; Hemorrhoidectomy; Humans; Metronidazole; Ointments; Pain; Prospective Studies; Retrospective Studies
PubMed: 34897211
DOI: 10.1097/DCR.0000000000002163 -
The American Journal of the Medical... 1980Seven patients with Bacteroides fragilis infections were treated with intravenous and/or oral metronidazole. Infections treated included endocarditis, osteomyelitis,...
Seven patients with Bacteroides fragilis infections were treated with intravenous and/or oral metronidazole. Infections treated included endocarditis, osteomyelitis, lung abscess, empyema, peritonitis, septicemia, and pelvic infection. Some patients had failed to respond to therapy with chloramphenicol or clindamycin or both. Metronidazole was used alone or in combination with aminoglycosides. Serum levels of metronidazole several times in excess of the minimal inhibitory concentrations for the organisms were easily achieved and in one patient the CSF metronidazole level was equal to that of the serum. Response to therapy with metronidazole was considered to be excellent. The only serious side effect noted was hypotension, which occurred in the last patient. Therapy was discontinued, and therefore therapeutic results could not be evaluated. Metronidazole appears to be a safe and effective agent in the treatment of B fragilis infections.
Topics: Adult; Aged; Bacteroides Infections; Bacteroides fragilis; Female; Humans; Male; Metronidazole; Microbial Sensitivity Tests; Middle Aged
PubMed: 7457495
DOI: 10.1097/00000441-198011000-00002 -
International Journal of Gynaecology... 1978Vaginal trichomoniasis was treated with standard courses of oral metronidazole in 597 pregnant women. In 283 other pregnant women, the infection remained untreated. The...
Vaginal trichomoniasis was treated with standard courses of oral metronidazole in 597 pregnant women. In 283 other pregnant women, the infection remained untreated. The incidences of low-birth-weight infants, stillbirths and congenital abnormalities were not affected by metronidazole treatment of trichomoniasis in pregnancy.
Topics: Abnormalities, Drug-Induced; Administration, Oral; Drug Evaluation; Female; Humans; Metronidazole; Pregnancy; Pregnancy Complications, Infectious; Trichomonas Vaginitis
PubMed: 29796
DOI: 10.1002/j.1879-3479.1977.tb00742.x -
The Journal of Antimicrobial... May 1977
Topics: Amebiasis; Anaerobiosis; Animals; Bacterial Infections; Female; Giardiasis; Humans; Metronidazole; Radiation-Sensitizing Agents; Trichomonas Vaginitis
PubMed: 559669
DOI: 10.1093/jac/3.3.205 -
Archives of Disease in Childhood Jul 1983Twenty four neonates at high risk of anaerobic sepsis were treated with intravenous metronidazole, 7.5 mg/kg, 8 hourly, for a mean period of 5 days. The highest observed...
Twenty four neonates at high risk of anaerobic sepsis were treated with intravenous metronidazole, 7.5 mg/kg, 8 hourly, for a mean period of 5 days. The highest observed concentration after the first dose (mean +/- SD) 9.6 +/- 4.0 mg/l (56.1 +/- 23.4 mumol/l) was significantly lower (P less than 0.001) than the highest observed concentration after the final dose (mean +/- SD) 19.3 +/- 8.6 mg/l (112.7 +/- 50.2 mumol/l). The overall metronidazole half life was (mean +/- SD) 23.4 +/- 13.1 hours. The half life after the first dose (mean +/- SD) 21.9 +/- 10.1 hours was not appreciably different from the half life after the final dose (mean +/- SD) 21.6 +/- 12.4 hours. The concentrations of the major metabolite of metronidazole (20396RP) also rose appreciably during treatment. No side effects of metronidazole were noted and its extended half life in neonates suggests that less frequent dosage would be appropriate.
Topics: Bacterial Infections; Female; Half-Life; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Injections, Intravenous; Kinetics; Metronidazole
PubMed: 6870333
DOI: 10.1136/adc.58.7.529