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PRODUCT TYPE:- METRONIDAZOLE
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It is active against a wide variety of anaerobic protozoal parasites and anaerobic bacteria, this compound is directly trichomonacidal. It has potent amoebicidal activity against E. histolytica and G.lambia, metronidazole manifests antibacterial activity against all anaerobic cocci and both anaerobic gram negative bacilli, including bacteroides species and anaerobic spore forming gram positive bacilli, it is clinically effective in trichomoniasis, amoebiasis and giardiasis, as well as in a variety of infections caused by obligate bacteria, including bacteroides, clostridium and helicobacter species. It may facilitate extraction of adult guinea worms in dracunculiasis.
INDICATIONS:
Amoebiasis, giardiasis, trichomoniasis, serious infections due to susceptible anaerobic bacteria including bacteroides, clostridium, fusobacterium peptococcus, peptostreptococcus, eubacterium and helicobacter. Together with other antibiotics, prophylaxis of postsurgical mixed bacterial infection for the treatment of gastric infections with H. pylori.
CONTRAINDICATIONS:
Neurological disorders, blood dyscrasias, hepatic failure and first trimester of pregnancy.
SAFETY PROFILE:
Metronidazole should be withdrawn of neurological symptoms like numbness, parasthesia, dizziness, vertigo, encephalopathy, convulsion, ataxia. Alcoholic beverages should be avoided. The doses should be reduced in patients with severe hepatic diseases.
ADVERSE EFFECTS:
Stpmatitis, nausea, anorexia, headache, metallic taste in mouth or dry mouth. Vomiting, diarrhea, and abdominal distress are experienced. Furry togue, glossitis may occur. Neurological symptoms may appear at high doses. Dark urine, vertigo, insomnia, may appear, Metronidazole has a disulfiram like effect and nausea, vomiting can occur if alcohol is ingested during therapy.
DRUG INTERACTIONS:
Disulfiram like reaction with alcohol potentiate anticoagulant effect of signs of lithium toxicity. Metronidazole levels may be elevated with cimetidine.
DOSAGE:
For the treatment of all symptomatic forms of amoebiasis. The recommended dose of metronidazole is 500-750 mg taken orally three times daily for 10 days. The daily dose for children is 35-50 mg/kg given in three divided doses for 10 days. For trichomniasis the usual regimen is 250 mg given three times a day for 5 days in children. Intravenous regimen for severe anaerobic infections\ is a loading dose of 15 mg/kg followed 6 hourly later by a maintenance dose of 7.5 mg/kg every 6 hours for 7-10 days.