Erdman - Metronidazole

Question 1

Metronidazole mechanism of action

Answer 1

Ultimately it inhibits DNA synthesis

Question 2

What is the antibacterial effect of metronidazole

Answer 2

Concentration dependent bactericidal activity

Question 3

Metronidazole mechanisms of resistance

Answer 3

-Altered growth requirements (bacteria grow in higher local oxygen concentrations)
-Altered ferredoxin levels

Question 4

Metronidazole spectrum of activity

Answer 4

-Best used for BDA
-ALL bacterioides
-ALL clostridiums

Question 5

Metronidazole distribution

Answer 5

Penetrates the CSF very well (50-100%)

Question 6

Metronidazole clinical uses

Answer 6

-Anaerobic infections in the intraabdominal, pelvic regions or in infected diabetic foot and decubitus ulcers as well as brain abscesses
-Pseudomembranous colitis due to C. diff (alternative agent when PO vanco is unavailable)
-Trichomonas
-Giardia

Question 7

Metronidazole adverse effects

Answer 7

-Stomatitis
-Metallic taste
-Peripheral neuropathy
-Avoid during pregnancy and breastfeeding

Question 8

Metronidazole drug interactions

Answer 8

-Warfarin (increased anticoagulant effect)
-Alcohol (disulfiram reaction)