Metronidazole

Question 1

What are the indications for metronidazole?

Answer 1

Anaerobic infections e.g. c diff
Bacterial vaginosis
H.pylori
Oral infections
Pelvic inflammatory disease
Trichomoniasis

Question 2

What bacteria does metronidazole have activity against?

Answer 2

Anaerobic bacteria and protozoa

Question 3

What are the contraindications and cautions for metronidazole?

Answer 3

In severe liver impairment reduce the dose by a third and give once daily.

Question 4

What are the interactions you need to be aware of with metronidazole?

Answer 4

Alcohol: disulfram reaction
Warfarin: bleeding

Question 5

What are the adverse effects associated with metronidazole?

Answer 5

Darkening of urine
Furred tongue
Pancreatitis
taste disturbance
Thrombocytopenia

Question 6

What are the patient and carer advice

Answer 6

Avoid alcohol during and for 48 hours after
Take with or just after food or meal

Question 7

Can you give metronidazole in pregnancy?

Answer 7

Only if benefit outweighs risk- avoid high doses

Question 8

Can you give metronidazole if a patient is breastfeeding?

Answer 8

Safe usually just avoid large single doses

Question 9

What is an important point to note about Tinidazole

Answer 9

It has a longer action than metronidazole

Question 10

What is the absorption of metronidazole like?

Answer 10

Very well absorbed orally and so IV route reserved for severe infections.

Question 11

Do you get systemic absorption with topical use?

Answer 11

Yes

Question 12

Whats the usual dose of metronidazole?

Answer 12

400-500mg TDS for 5 to 7 days