Abstract
Metronidazole is a nitroimidazole compound active in the treatment of anaerobic protozoan and bacterial infections. It can be administered by the oral, intravenous, rectal, and intravaginal route. Metronidazole possesses limited toxicity and is, in general, very well tolerated. Widely used in the treatment of Trichomonas vaginalis and bacterial vaginosis, it is also useful in the management of Clostridium difficile colitis and amebiasis. It is also used in combination with aminoglycosides to provide coverage of anaerobic organisms in patients with polymicrobial pelvic and abdominal infections. Adverse reactions usually are limited to mild gastrointestinal symptoms such as nausea and diarrhea. Patients should be cautioned to abstain from alcohol ingestion while taking metronidazole to avoid a disulfiram reaction. Earlier concerns regarding teratogenicity and carcinogenicity have been shown to be unfounded in longitudinal studies of patients exposed to metronidazole. In addition, metronidazole is relatively inexpensive.