Metronidazole.ppt

A nitroimidazole antibiotic used particularly for;
Anaerobic bacteria &
Protozoa
Its an antimicrobial drug which is highly active against;
Anaerobic bacteria
Some protozoa
Amoeba
Thus metronidazole is an;
Antibiotic drug
Ameobicide
Antiprotozoal
Its common trade name is Fragyl in USA & Uganda
Tinidazole is similar to metronidazole but with a long duration of action

1. Dr. NDAYISABA CORNEILLE
CEO of CHG
MBChB,DCM,BCSIT,CCNA
SupportedBY
METRONIDAZOLE

2. Anitroimidazoleantibioticusedparticularlyfor;
Anaerobicbacteria&
Protozoa
Itsanantimicrobialdrugwhichishighlyactive
against;
Anaerobicbacteria
Someprotozoa
Amoeba

3. Thusmetronidazoleisan;
Antibioticdrug
Ameobicide
Antiprotozoal
ItscommontradenameisFragylinUSA&Uganda
Tinidazoleissimilartometronidazolebutwitha
longdurationofaction

4. Anti-bacterial,anti-protozoal&amoebicactivityof
metronidazole
Thisdrugiskills;
1.Anaerobicbacterialike;
Bacteroidesfragilisspp
Fusobacteriumspp
Clostridiumspp;c.tetani,c.difficile,
c.perfringens

5. Peptococcus spp
Peptostreptococcus spp
Prevotella spp etc
2.Protozoalikegiardialambliawhichcozgiardiasis
3.Amoebalikeentamoebahistolyticawhichcancoz
bacillarydysentery,hepaticabscess(amoebema)

6. Pharmacodynamics
Mechanismofaction
Metroisselectivelyabsorbedbyanaerobic
bacteria,sensitiveprotozoa&amoeba
Withinthesemicro-organismsfragylis
convertedtoatoxicformthatdamagesthe
DNAofthemicroorganisms

7. Pharmacokinetics
Its available in form of;
Tabs
Syrups
IV solutions
Topical application gel
Rectal preparations (suppositories)

8. Metronidazole shld always be taken;
With a large glass of water
With or after food
Whengivenorallyitsrapidly&completely
absorbedfrmgut
Itsdistributedrapidlythroughoutalltissues&body
fluids+CSF

9. Someismetabolised&mostisexcretedinurine
Plasmahalflifeisabout7hrs

10. Dosage
Adult:
PO; (varies depending on disease)
200-400mg 2-3 times /d (common)
800mg start then 400mg 3 times/d
250-500mgs 2-3 times/d
2g start
IV;500mg 2-3 times /d

11. Pediatric dosage:
PO; 15mg/kg 3 times /d
IV;7.5 mg/kg 3 times /d

12. INDICATIONS OF
METRONIDAZOLE

13. 1. Anaerobic bacterial infections like
Intra-abdominal abscess
Peritonitis
Empyema
Aspiration pneumonia
Lung abscess
Diabetic foot ulcer
Septicemia

14. Meningitis & brain abscess
Bone & joint infections
Septic wounds
Endometritis
Tubo-ovarian abscess
Endocarditis

15. 2.Surgicalprophylaxis2hrsbeforesurgeryinhigh
riskprocedureslikecolorectalsurgeryor
appendectomies
3.Surgical&gynecologicalsepticaemiadueto
colonicanaerobeslikebacteroidesfragilis
4.Amoebicdysenteryduetoentamoebahistolytica

16. 5.Txofsymptomaticbacterialvaginosisdueto
overgrowthofgardnerellaspp&co-infective
anaerobes(mobiluncus,bacteroides)
6.PseudomembranouscolitisduetoClostridium
difficile
7.Txofpepticulcerdiseasebyeradicating
Helicobacterpyloriinatripletherapyregimen

17. 8.Establishedcasesoftetanusincombinationwith
diazepam&tetanusimmunoglobulin
9.Oralinfectionslikeacutenecrotizingulcerative
gingivitis&otherdentalinfections
10.Txofpelvicinflammatorydiseaseincombination
withotherantibioticslikeofloxacin,levofloxacin,
doxycyclineorceftriaxone

18. 11.Txofsepticlegulcers&pressuresores
12.Treatmentofgiardiasiswhichisaprotozoa
infectionleadingtononbloodydiarrhoea&GISx
13.Crohn'sdiseasewithcolonicorperianal
involvementincombinationwithciprofloxacin
14.Txoftrichomonalvaginitisduetoprotozoa
trichomonasvaginalis

19. Indicationsfortopicalmetronidazole
1.Treatmentofrosacea
2.Treatmentofmalodorousfungatingwounds
3.Killingofmalodorousproducinganaerobic
bacteriainfungatingtumorslikemalignant
melanomas

20. unwanted effects
of
metronidazole

21. Its has few S/Es
1. Minor Gl disturbances like
Metallic & bitter mouth taste
Nausea & vomiting
Anorexia
Diarrhoea
Furred tongue
Oral mucositis
2. Thrombophlebitis after IV drug

22. OtherveryrareS/Es
1.Blooddisorderslikethrombocytopenia,
neutropenia,pancytopeniaetc
2.Hypersensitivityreactionslike;
Rash
Pruritus
Fevers
Flushingoftheskin

23. 3. CNS disturbances
Dizziness
Drowsiness
Headache
Ataxia (staggering gait)
Psychosis
Seizures
Sensory neuropathies

24. 4.Hepatitis
5.Jaundice
6.Pancreatitis
7.Visualdisturbances
8.Myalgias&arthralgias
9.Darkeningofurine

25. Contraindications
1.Firsttrimesterofpregnancy
2.Relativelycontraindicatedinptswithhepatic
impairment&hepaticencephalopathy
3.Concurrentintakeofalcoholwithmetronidazole
bcozFragylinhibitsalcoholmetabolismleadingto
flushing,DIB,tachycardia,N&Vetc
4.Acuteporphyria

26. END
BY
DR NDAYISABA CORNEILLE
MBChB,DCM,BCSIT,CCNA,Cyber Security
contact: [email protected] ,
[email protected]
whatsaps:[phone] /[phone]
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