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Metronidazole
1H Imidazole 1 Ethanol 2 Methyl 5 Nitro

Images

WIKIDATA, Public Domain
WIKIDATA, Public Domain
WIKIDATA, Public Domain
WIKIDATA, CC BY-SA 4.0
WIKIDATA, Public Domain

Presentation

We present, here, a case of a 34-year-old man, presenting with garbled speech and word finding difficulty. He was taking metronidazole for the last 3 months for stage 4 decubitus ulcers. [ncbi.nlm.nih.gov]

Entire Body System

  • Fatigue

    Chronic Fatigue Syndrome (CFS) Symptoms and Diagnosis Chronic fatigue syndrome (CFS) can occur at any age for men or women. Learn more about the causes of chronic fatigue syndrome... [medicinenet.com]

    With the pill I experienced daily headaches, a feeling of being distorted, fatigue, dizziness, nausea, diarrhea, a stiff neck, and a metal taste in my mouth. I never had BV until the year 2011 after being sex-free for 3 years after my divorce. [webmd.com]

    Side effects: irritated heartbeat, palpatations, breathlessness, dizziness, anxiety, flue like symptoms, extreme fatigue, tingling, pain in arm Comments: prescribed tablets by Dentist for gum infection. i was told i should take antibiotics but nothing [druglib.com]

    Adverse reactions CNS: dizziness, headache, ataxia, vertigo, incoordination, insomnia, fatigue EENT: rhinitis, sinusitis, pharyngitis GI: nausea, vomiting, diarrhea, abdominal pain, furry tongue, glossitis, dry mouth, anorexia GU: dysuria, dark urine, [medical-dictionary.thefreedictionary.com]

  • Intravenous Administration

    Intravenous administration produces similar maternal plasma and milk levels to equivalent oral doses, although the data are limited. Short-course IV metronidazole is considered to be compatible with breastfeeding. [sps.nhs.uk]

    For both intravenous and oral administration, a linear dose-concentration curve pertained for usual therapeutic doses between 200 and 2000mg. [link.springer.com]

    In therapeutic use as radiosensitizers for radiation therapy of tumors, the compounds of the present invention may be administered to a patient either orally or intravenously. The preferred route of administration is intravenous administration. [patents.google.com]

Gastrointestinal

  • Nausea

    Amoebiasis (parasitic infection of the intestines) Amebic colitis (watery diarrhea, abdominal pain, and loss of appetite) An amebic liver abscess (collection of pus in the liver) Giardiasis (intestinal infection marked by stomach cramps, bloating, nausea [rxlist.com]

    Side Effects Dizziness, headache, stomach upset, nausea, vomiting, loss of appetite, diarrhea, constipation, or metallic taste in your mouth may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. [webmd.com]

    Key facts The most common side effects of metronidazole tablets, liquid, suppositories or vaginal gel are feeling sick (nausea) or being sick (vomiting), diarrhoea, and a slight metallic taste in your mouth. [nhs.uk]

    The most common side effects that have been reported are nausea, vomiting and hypersensitivity reactions. However, neurotoxicity has been reported with the use of metronidazole but rather rare. [ncbi.nlm.nih.gov]

  • Abdominal Pain

    Blastocystis sp. is a gastrointestinal (GI) protozoan parasite reported to cause non-specific GI symptoms including diarrhea, flatulence, abdominal pain, and nausea. [ncbi.nlm.nih.gov]

    Symptoms of peptic or stomach ulcers include abdominal burning or hunger pain, indigestion, and abdominal discomfort after meals. Treatment for stomach ulcers depends upon the cause. [medicinenet.com]

    Depression Sleep disorder Nervousness Perineal pain Urinary difficulties Headache Musculoskeletal pain Vaginal estradiol: Headache Vulvovaginal mycotic (fungal) infection Vulvovaginal pruritus (itching) Back pain Abdominal pain Diarrhea Vaginal metronidazole [rxlist.com]

    Metallic taste in the mouth, nausea, upper abdominal pain or headaches sometimes occur following usual therapeutic doses. Convulsions, ataxia, skin problems (skin rashes, urticaria), and vaginal candidiasis are not as common. [infomed.ch]

    Abdominal pain, bloat, chronic or intermitant diarrhea and steaturrhea which cause malabsorption are the main clinical signs. The etilogic agent is Giardia lamblia which is found in the form of trophozite (pathogenic form) and cyst (infective form). [nature.com]

Jaw & Teeth

  • Metallic Taste

    Can the use of Metronidazole cause metallic taste? Yes, Metronidazole may cause a temporary metallic taste. This metallic taste can be reduced by staying hydrated, brushing teeth after the meals and chewing sugar-free gum or mints. Q. [1mg.com]

    The metal taste in my mouth is a little irritating, my appetite is decreased, and I feel a little groggier than usual, but it's really not so bad. Just thought I would write a review to ease some people's mind... [webmd.com]

    Key facts The most common side effects of metronidazole tablets, liquid, suppositories or vaginal gel are feeling sick (nausea) or being sick (vomiting), diarrhoea, and a slight metallic taste in your mouth. [nhs.uk]

    Adverse Reactions: Nausea, headache, anorexia, vomiting, diarrhea, epigastric distress, abdominal cramping, constipation, metallic taste, dysuria, cystitis; seizures, encephalopathy, optic/peripheral neuropathy, aseptic meningitis. [empr.com]

    Metallic taste in the mouth, nausea, upper abdominal pain or headaches sometimes occur following usual therapeutic doses. Convulsions, ataxia, skin problems (skin rashes, urticaria), and vaginal candidiasis are not as common. [infomed.ch]

Skin

  • Eczema

    Demodex mites are more frequently found in rosacea (51%) compared to 28 percent in eczema and 31 percent in discoid lupus erythematosus [ 13 ]. [dermatology.cdlib.org]

    Some physicians use a thick ointment to replace the waterproof barrier of the inflamed skin in the treatment of eczema, and a cream might not accomplish the same clinical intention Classes[edit] There are many general classes, with no clear dividing line [en.wikipedia.org]

Musculoskeletal

  • Arthralgia

    […] pressure[Ref] Respiratory Common (1% to 10%): Upper respiratory tract infection, rhinitis, sinusitis, pharyngitis Frequency not reported: Dyspnea, nasal congestion, hiccup[Ref] Musculoskeletal Common (1% to 10%): Myalgia Very rare (less than 0.01%): Arthralgia [drugs.com]

Neurologic

  • Headache

    Symptoms may include headache, lethargy, fever, and focal neurologic deficits. Diagnosis is by contrast-enhanced MRI or CT. [msdmanuals.com]

    A disulfiram-like reaction (including flushing, headache, nausea, and vomiting) may occur if alcohol is ingested within 7 days of use. [merckmanuals.com]

    During the metronidazole treatment, loss of sight, vertigo, ataxia, and headache occurred as the adverse effects. By this report, we want to express the rare adverse effects of drugs in the differential diagnoses of nervous system diseases. [ncbi.nlm.nih.gov]

  • Peripheral Neuropathy

    Overall, metronidazole is generally well tolerated, but serious neurotoxicity, including peripheral neuropathy, has been reported. The overall incidence of peripheral neuropathy associated with metronidazole is unknown. [ncbi.nlm.nih.gov]

    Adverse effects of metronidazole include GI disturbances CNS effects and peripheral neuropathy Disulfiram-like reaction Nausea, vomiting, headache, seizures, syncope, other CNS effects, and peripheral neuropathy can occur; rash, fever, and reversible [msdmanuals.com]

    The duration and total dosage of metronidazole received is the primary determinant for patients developing peripheral neuropathy. [pharmaceutical-journal.com]

Treatment

There are reports of CDAD even after more than two months of postantibiotic treatment. [ncbi.nlm.nih.gov]

1 4 Completed Treatment Gingival Inflammation 1 4 Completed Treatment Helicobacter Infection 1 4 Completed Treatment Helicobacter Infections 2 4 Completed Treatment Helicobacter Pylori Treatment Failure 1 4 Completed Treatment Human Immunodeficiency [drugbank.ca]

Medical treatment of peptic ulcer disease. JAMA. 1996; 275:622-9. [IDIS 361115] [PubMed 8594244] 377. Soll AH. Practice guidelines for treatment of peptic ulcer disease. JAMA. 1996; 276:1136-7. 378. [web.archive.org]

Treatment of antibiotic-associated pseudomembranous colitis. Rev Infect Dis. 1984; 6(Suppl 1):S235-41. 129. Fekety R, Silva J, Buggy B et al. Treatment of antibiotic-associated colitis with vancomycin. [drugs.com]

Prognosis

We advocate that metronidazole can be associated with severe neurotoxicity, but its prompt cessation leads to better outcome and prognosis. [ncbi.nlm.nih.gov]

[…] medulla, and pons ADC: ADC values of lesions of the dentate nucleus, midbrain, medulla, and pons are similar or higher than those of normal white matter, whilst corpus callosum lesions can show lower values than in normal white matter 3 Treatment and prognosis [radiopaedia.org]

When skin detachment is extensive, however, the prognosis is poor. [doi.org]

Usually, the prognosis for peripheral neuropathy is good if the cause can be successfully treated or prevented. [medicinenet.com]

Etiology

Recall dermatitis from primary cutaneous exposure and subsequent oral exposure are rare, and the etiology remains unknown. We report a case of recall dermatitis with a drug eruption secondary to metronidazole. [ncbi.nlm.nih.gov]

Martin Tomy and Hui LI, Severe cutaneous adverse drug reactions: a review on epidemiology, etiology, clinical manifestation and pathogenesis, Chinese Medical Journal, 10.1097/00029330-200804020-00019, 121, 8, (756-761), (2008) ., Current awareness: Pharmacoepidemiology [dx.doi.org]

Epidemiology

The incidence and microbiologic epidemiology of NIP and VAP were studied. RESULTS: There were 873 patients enrolled. [ncbi.nlm.nih.gov]

Biology and Epidemiology 3.2.1.1.2. Chemotherapy 3.2.1.2. American Trypanosomiasis 3.2.1.2.1. Biology and Epidemiology 3.2.1.2.2. Chemotherapy 3.2.1.3. Leishmaniasis 3.2.1.3.1. Biology and Epidemiology 3.2.1.3.2. Chemotherapy 3.2.2. [doi.org]

Martin Tomy and Hui LI, Severe cutaneous adverse drug reactions: a review on epidemiology, etiology, clinical manifestation and pathogenesis, Chinese Medical Journal, 10.1097/00029330-200804020-00019, 121, 8, (756-761), (2008) ., Current awareness: Pharmacoepidemiology [dx.doi.org]

Pathophysiology

Pathophysiological mechanisms of metronidazole neurotoxicity remain unclear. MRI Nearly all cases show lesions in the cerebellum (93-100%) 1,3, particularly of the cerebellar dentate nuclei. [radiopaedia.org]

Tran and Joseph Poku, Hemodynamic Considerations in the Pathophysiology of Peripheral Neuropathy, Blood Pressure - From Bench to Bed, 10.5772/intechopen.75872, (2018). J. Morera-Montes and M. [dx.doi.org]

Hepatic encephalopathy: Pathophysiology and emerging therapies. Med Clin N Am 2008;93:819-836. Morgan MH, Read AE, Speller DC. Treatment of hepatic encephalopathy with metronidazole. Gut 1982;23:1-7. Schiano Thomas D. [medigraphic.com]

Discussion The exact pathophysiology of hemorrhoidal disease remains poorly studied and understood. [scielo.isciii.es]

Prevention

Recurrent Bacterial Vaginosis 1 3 Completed Prevention Appendicitis Acute / Perforated Gastroduodenal Ulcer / Small intestinal obstruction 1 3 Completed Prevention Bacterial Vaginosis (BV) 2 3 Completed Prevention Human Immunodeficiency Virus (HIV) Infections [drugbank.ca]

Astodrimer prevents BV-causing bacteria from attaching to the vaginal lining. Astodrimer also has antiviral effects and is being investigated for use in the prevention of viral infections such as HSV-2 and HIV. [rxlist.com]

[…] bacterial infections. antiparasitic agent A substance used to treat or prevent parasitic infections. radiosensitizing agent A drug that makes increases the sensitivity of tumour cells to radiation therapy. [ebi.ac.uk]

Article Navigation From the Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, and the Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine [doi.org]

KEYWORDS: H. pylori; bactericidal dynamics; human lysozyme; metronidazole; mutant prevention concentration [ncbi.nlm.nih.gov]

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