Metronidazole
Although metronidazole is generally well tolerated with minimal adverse effects, patients have
reported a variety of reactions across physiological systems.
Central Nervous System. Headache, dizziness, vertigo, incoordination, ataxia, confusion, dysarthria,
irritability, depression, weakness, and insomnia have been reported by patients taking metronidazole
. More severely, patients have reported convulsive seizures, encephalopathy, aseptic meningitis,
optic/peripheral neuropathy (namely numbness and parasthesias) during treatment (Sarna, Furtado
Brownell, 2013, p. 768).
Gastrointestinal. Nausea (with or without headache or vomiting,) diarrhea, epigastric distress,
abdominal cramping, and constipation are the most common adverse effects reported during
metronidazole therapy. Patients have commonly reported a sharp, metallic taste; glossitis and
stomatitis have occurred, and may be related to Candida overgrowth during successful therapy;
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Mayer et al. (2015) examined the rapid and significant changes to vaginal microbiota following
antibacterial treatment for BV, and found that metronidazole, although the first line treatment for
BV, is not effective ultimately effective against G. vaginalis; within 24 hours of administration,
there was complete reorganization of the vaginal microbiota, with G. vaginalis reemergence within
7 days. It is speculated that drug resistance may be partially responsible for their results. By
contrast, Waheed, Yaseen Shami (2015) evaluated the most effective therapy to prevent
complications of pregnancy caused by BV, and obtained a 74% cure rate using 0.75%
metronidazole cream; this was similar in results to use of 2% clindamycin vaginal cream, although
the clindamycin regimen is shorter in duration (p.
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