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Metronidazole (Flagyl)

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Metronidazole belongs to the class of medicines known as antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.

Other names for this medication:
Acea, Acuzole, Aldezol, Aldezole, Amebidal, Amevan, Aminidazole, Amobin, Amodis, Amotein, Amotrex, Amrizole, Anabact, Anaerobex, Anaeromet, Anamet, Anazol, Anegyn, Anerobia, Anerozol, Arilin, Aristogyl, Asuzol, Avidal, Bemetrazole, Bi missilor, Biatron, Biozyl, Birodogyl, Buccoval, Camezol, Chemagyl, Clont, Collazole, Colpocin t, Colpofilin, Corsagyl, Cresac, Dazotron, Deflamon, Deprocid, Dequazol, Diazole, Dirozyl, Dumozol, Efectimax, Efloran, Elyzol, Emedal, Entizol, Etron, Etronil, Farnat, Filmet, Fladex, Fladystin, Flagemed, Flagenase, Flagicure, Flagolin, Flagystatin, Flagystatine, Flanizol, Flazol, Flazole, Flegyl, Florazole, Fortagyl, Geloderm, Giardyl, Ginerella, Ginkan, Gnostol, Grinazole, Gynomix, Gynoplix, Gynotran, Imizine, Kilpro, Klion, Klont, Lindoplus, Litagyl, M-zed, Mebadiol, Mecozol, Medamet, Medazol, Menilet, Menizol, Menizol benzoil, Metazol, Metazole, Metco, Metrajil, Metral, Metrazol, Metren, Metrin, Metris, Metro, Metrobac, Metrocev, Mtrocol, Metrocream, Metrocreme, Metrodal, Metroderme, Metrofusin, Metrogel, Metrogyl, Metrol, Metrolag, Metrolotion, Metrolyl, Metronex, Metronid, Metronidazol, Metronidazolas l, Mtronidazole, Metronidazols, Metronidazolum, Metronide, Metronour, Metropast, Metrosa, Metrosept, Metroseptol, Metrosil, Metroson, Metrovax, Metrozin, Metrozine, Metrozol, Metrozole, Metryl, Metsina, Micogyl, Minegyl, Missilor, Molazol, Monizole, Nalox, Negazole, Neo gynoxa, Nidagel, Nidagyl, Nidazea, Nidazol, Nidazole, Nidazyl, Nipazol, Nizole, Nor-metrogel, Noritate, Norzol, Novazole, Onida, Orogyl, Orvagil, Otrozol, Padet, Patryl, Perilox, Pharmaflex, Polibiotic, Promuba, Protogyl, Protozol, Repligen, Rhodogil, Riazole, Robaz, Rodogyl, Rosaced, Rosalox, Rosasol, Rosazol, Rosiced, Rovamet, Roza, Rozacrme, Rozagel, Rozamet, Rozex, Rupezol, Servizol, Sharizol, Stomorgyl, Strazyl, Suanatem, Supplin, Taremis, Tismazol, Tolbin, Torgyl, Trichazole, Trichex, Trichodazol, Trichomonacid, Trichopol, Trichostatic, Trichozole, Tricodazol, Tricofin, Triconex, Tricowas b, Tricozyl, Trikozol, Trogyl, Unigyl, Vagi-metro, Vagilen, Vagimid, Vagizol, Vandazole, Varizil, Venogyl, Vertisal, Wingyl, Zidoval, Zobacide, Zyomet

Similar Products:
Amoxil, Bactrim, Ampicillin, Augmentin, Macrobid, Trimox, Tinidazole, Biaxin, Chloromycetin, Myambutol


Also known as:  Flagyl.


Metronidazole (generic name: Metronidazole) is an antibiotic that belongs to a group of medicines called nitroimidazoles.

Metronidazole is used for the treatment of susceptible anaerobic bacterial and protozoal infections in the following conditions: amebiasis, symptomatic and asymptomatic trichomoniasis; skin and skin structure infections; CNS infections; intra-abdominal infections (as part of combination regimen); systemic anaerobic infections; treatment of antibiotic-associated pseudomembranous colitis (AAPC); bacterial vaginosis; as part of a multidrug regimen for H. pylori eradication to reduce the risk of duodenal ulcer recurrence.


Metronidazole 250-mg tablets are round, blue, film coated, with SEARLE and 1831 debossed on one side and Metronidazole and 250 on the other side; bottles of 50, 100, and 2,500. Metronidazole 500-mg tablets are oblong, blue, film coated, with Metronidazole debossed on one side and 500 on the other side; bottles of 50, 100, and 500.


Single oral doses of Metronidazole, up to 15 g, have been reported in suicide attempts and accidental overdoses. Symptoms reported include nausea, vomiting, and ataxia. Oral Metronidazole has been studied as a radiation sensitizer in the treatment of malignant tumors. Neurotoxic effects, including seizures and peripheral neuropathy, have been reported after 5 to 7 days of doses of 6 to 10.4 g every other day.

There is no specific antidote for Metronidazole overdose; therefore, management of the patient should consist of symptomatic and supportive therapy.


Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

Side effects

The most common side effects associated with Metronidazole are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


Metronidazole is mainly metabolised by hepatic oxidation. Substantial impairment of Metronidazole clearance may occur in the presence of advanced hepatic insufficiency. The risk/benefit ratio of using Metronidazole to treat trichomoniasis in such patients should be carefully considered. Plasma levels of Metronidazole should be closely monitored.

Cases of severe hepatotoxicity/acute hepatic failure, including cases with a fatal outcome with very rapid onset after treatment initiation in patients with Cockayne syndrome have been reported with products containing metronidazole for systemic use. In this population, metronidazole should therefore be used after careful benefit-risk assessment and only if no alternative treatment is available. Liver function tests must be performed just prior to the start of therapy, throughout and after end of treatment until liver function is within normal ranges, or until the baseline values are reached. If the liver function tests become markedly elevated during treatment, the drug should be discontinued.

Patients with Cockayne syndrome should be advised to immediately report any symptoms of potential liver injury to their physician and stop taking metronidazole.

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The prevalence of methicillin-resistant Staphylococus aureus (MRSA) has increased worldwide and MRSA has emerged as an important cause of sepsis in cirrhotic patients and liver transplant recipients. In this retrospective study, the prevalence of MRSA colonization and its influence on infections following orthotopic liver transplantation (OLT) was investigated. From August, 2002 until November, 2004, 66 primary cadaver OLT were performed for adult recipients. Antibody induction used Daclizumab (n = 49) or ATG (n = 14). Maintenance immunosuppression consisted of tacrolimus and steroids, with 30 patients receiving mycophenolate mofetil and 4, rapamune. For perioperative anti-infectious prophylaxis cefotaxime, metronidazole, and tobramycin were administered for 48 hours. The preoperatively performed routine swabs revealed MRSA colonization in 12 of 66 (18.2%) patients. The stage of cirrhosis was equivalent for MRSA(-) patients according to Child score. The mean MELD score was significantly higher for MRSA(+) patients (24.3 versus 18.7, P = .036). More MRSA(+) patients were hospitalized at the time of transplantation (14/54 versus 8/12, P = .018). The incidence of posttransplant infections was not significantly different among the two groups. Within the first year 7 of 66 (10.6%) patients died: 3 of 12 (25%) MRSA(+) and 4 of 54 (7.4%) MRSA(-). The 1-year survival was lower in the MRSA(+) group (74.1% versus 94.1%). In conclusion, this study did not show that an MRSA-positive carrier status implies an increased risk for septic complications following OLT. Mortality was increased for MRSA(+), but failed to show a significant difference. A significantly higher MELD score and pretransplant hospitalization for MRSA(+) patients may contribute to the higher mortality and reflect sicker patients.

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Lon in Helicobacter pylori (HpLon) interacting partners are mostly associated with metronidazole activation. lon mutant presents more susceptible to metronidazole than that of the wild type, and this phenotype is recovered by complementation of the wild-type Lon. We found that the ATPases associated with a variety of cellular activities (AAA(+) ) module of HpLon causes a decrease in both NADPH oxidase and Mtz reductase activity in RdxA, a major Mtz-activating enzyme in H. pylori.

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Conditional targeted cell ablation in zebrafish would greatly expand the utility of this genetic model system in developmental and regeneration studies, given its extensive regenerative capabilities. Here, we show that, by combining chemical and genetic tools, one can ablate cells in a temporal- and spatial-specific manner in zebrafish larvae. For this purpose, we used the bacterial Nitroreductase (NTR) enzyme to convert the prodrug Metronidazole (Mtz) into a cytotoxic DNA cross-linking agent. To investigate the efficiency of this system, we targeted three different cell lineages in the heart, pancreas, and liver. Expression of the fusion protein Cyan Fluorescent Protein-NTR (CFP-NTR) under control of tissue-specific promoters allowed us to induce the death of cardiomyocytes, pancreatic beta-cells, and hepatocytes at specific times. Moreover, we have observed that Mtz can be efficiently washed away and that, upon Mtz withdrawal, the profoundly affected tissue can quickly recover. These findings show that the NTR/Mtz system is effective for temporally and spatially controlled cell ablation in zebrafish, thereby constituting a most promising genetic tool to analyze tissue interactions as well as the mechanisms underlying regeneration.

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The aim of this study was to perform a pharmacodynamic analysis, using recent global surveillance data, of commonly prescribed antibiotic agents and a newer agent, tigecycline, indicated in 2005 for the treatment of complicated intra-abdominal infections, to determine their probability for achieving microbiologic success against aerobic bacteria associated with secondary peritonitis.

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It is controversial whether patients with non-ulcer dyspepsia (NUD) respond differently to Helicobacter pylori (H pylori) eradication treatment than those with peptic ulcer disease (PUD). To review the evidence for any difference in H pylori eradication rates between PUD and NUD patients.

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The electrochemistry of metronidazole, 1-(hydroxyethyl)-2-methyl-5-nitroimidazole, was investigated at a carbon fiber microdisk electrode in pH 9 Britton Robinson buffer. Under these conditions, the reduction of metronidazole is controlled by both mass transport to the microdisk and adsorption with an equilibrium constant of 4x10(3)mol(-1)dm(3) and a saturation coverage of 0.88x10(-8)molcm(-2). The adsorption and accumulation of metronidazole on the surface of the carbon fiber allows its determination at low concentrations by square wave adsorptive stripping voltammetry. A detection limit for metronidazole of 5x10(-7)moldm(-3) and a R.S.D. of 3.7% at 1x10(-6)moldm(-3) (n=4) were obtained with a two electrode system with no stirring during the accumulation step. Based on this method, a simple procedure for the determination of metronidazole in urine is described which requires no pre-treatment of the sample before analysis.

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To investigate the prevalence of the bacterial genes encoding resistance to beta-lactams, tetracyclines and metronidazole respectively, in subjects with successful and failing dental implants and to assess the presence of Staphylococcus aureus and the mecA gene encoding for Methicillin Resistant Staphylococcus aureus (MRSA) in the same samples.

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One-week triple therapy, consisting of tripotassium dicitrato bismuthate, low-dose furazolidone and low-dose clarithromycin, achieves a high cure rate of H. pylori.

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Dentists often prescribe antimicrobial agents to treat infections. Until recently, these agents also were recommended as prophylaxis for infective endocarditis during invasive oral procedures. An important risk factor for CDAD and recurrent CDAD is antimicrobial agent exposure. Dentists should be aware of CDAD to help prevent its spread and facilitate early recognition and treatment to minimize severe outcomes.

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Perianal sinuses resolved completely in 15 of 19 dogs during the 16 weeks. In the remaining 4 dogs, the lesions markedly improved but failed to completely resolve. Three of these had anal sac involvement, and the owner of 1 dog had complied poorly with treatment instructions. During the 2 years following treatment, all dogs were maintained on intermittently applied tacrolimus ointment, 4 dogs also received prednisone every other day, and 11 dogs remained on the novel-protein diet. At the conclusion of the study, 13 of the 15 dogs that survived to that point were free of perianal disease.

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Patients with unequivocal evidence of H. pylori infection based on culture, histology and rapid urease test of both antrum and corpus biopsies were recruited for the study. The study was a randomized, investigator-blind, comparative study. Patients received either omeprazole 20 mg o.m., clarithromycin 250 mg b.d. and amoxycillin 500 mg b.d. (OAC) or omeprazole 20 mg o.m., metronidazole 400 mg b.d. and clarithromycin 250 mg b.d. (OMC) for 1 week. Patients were assessed for successful eradication, which was defined as absence of bacteria in all tests (culture, histology and urease test on both antral and corpus biopsies), at least 4 weeks after completion of therapy.

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Helicobacter pylori infection causes progressive damage to gastric mucosa and results in serious disease such as peptic ulcer disease, MALT lymphoma, or gastric adenocarcinoma in 20% to 30% of patients. The current approach is to make a firm diagnosis, give combination antibiotic and antisecretory therapy, and confirm that the infection has been cured 4 to 6 weeks later. Antimicrobial resistance is largely responsible for treatment failures. Resistance to metronidazole can frequently be overcome by increasing the dose and duration of treatment with acid suppression. Clarithromycin is the most effective antibiotic against H. pylori but, unfortunately, resistance to it is increasing and can not be overcome by increasing the dose or duration of therapy with clarithromycin. The choice of therapy should be based on local susceptibility patterns. Re-treatment regimens for treatment failure should exclude antibiotics where acquired resistance is expected (i.e., clarithromycin and possibly metronidazole). Where available, treatment failure should prompt endoscopy and culture and susceptibility testing. Overall, higher doses and longer durations of treatment result in the best cure rates. When multiple treatment regimens fail, salvage therapy regimens such as bismuth or furazolidone quadruple therapy (a bismuth and tetracycline HCl 4 times a day along with a proton pump inhibitor twice a day, and either metronidazole 400 or 500 mg three times daily or furazolidone 100 mg three times daily for 14 days) can be used. Newer agents are needed to cope with the increasing prevalence of antibiotic resistance among H. pylori.

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The effects of dicloran gel in combination with antibiotics on salivary lipid peroxidation were evaluated in 18 patients aged 23-68 years with chronic generalized rapidly progressing periodontitis. Lipid peroxidation and activity of antioxidant systems surpassed the normal values 2-4-fold in periodontitis patients before treatment. After therapy with metrogil-dent these parameters decreased (p < 0 buy metronidazole .05). Injection of dicloran gel before antibiotic therapy induced a decrease in these parameters within approximately 30 min. If dicloran gel was injected after metrogil-dent, the maximum decrease in oxidative processes and antioxidant system activity was observed as soon as in 15 min.

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Clostridium difficile infection (CDI) is becoming more common worldwide. The morbidity and mortality associated with C difficile is also increasing at an alarming rate. Critically ill patients are at particularly high risk for CDI because of the prevalence of multiple risk factors in this patient population. Treatment Buy Zithromax Canada of C difficile continues to be a difficult problem in patients with severe or recurrent disease. This article seeks to provide a broad understanding of CDI in the intensive care unit, with special emphasis on risk factor identification, treatment options, and disease prevention.

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In childhood, laparoscopy-assisted single-port appendectomy (SPA), including the advantages of open and laparoscopic surgery, is not widely used. However, there is debate whether the retrieval of the infected appendix via the umbilicus results in a higher infection rate compared with other laparoscopic or open techniques. The aim of the study was to determine the postoperative infection rate and possible risk factors for infection Buy Metronidazole 500mg after SPA in children.

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A rapid, reproducible high-performance liquid chromatographic method for the determination of secnidazole, 5-nitroimidazole class of antiprotozoals from blood is described. Metronidazole was used as an internal standard. A simple extraction step with dichloromethane was done before chromatography on a C18 column with the wavelength fixed at 276 nm on the UV detector. Blood levels up to 500 ng/ml have been measured with good precision in the healthy volunteers after 1 g of secnidazole was administered. The present described method can readily Buy Metronidazole Gel 1 be utilized for routine pharmacokinetic studies.

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Prospective, observational study. This study was performed at the Cleveland Veterans Affairs Medical Center (Cleveland, OH). For patients with CDAD who had concurrent VRE colonization, stool, skin, and environmental samples were cultured for VRE before, during, and up to 3 weeks after therapy Buy Tetracycline Cream with metronidazole or vancomycin. The proportions of skin and environmental contamination were compared before and after resolution of diarrhea and during treatment with metronidazole or vancomycin.

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Ultrahigh performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) was utilized Buy Chloramphenicol Uk to develop a rapid, sensitive and reliable method without solid phase extraction (SPE) pre-concentration for trace analysis of 11 pharmaceuticals and personal care products (PPCPs) in influent and effluent from municipal wastewater treatment plants (WWTPs). This method not only shortened the analysis time but also reduced analysis cost significantly by omitting SPE process and avoiding the consumption of SPE cartridge. Detection parameters for UHPLC-MS/MS analysis were optimized, including sample pH, eluent, mobile phase (solvent and additive), column temperature, and flow rate. Under the optimal conditions, all analytes were well separated and detected within 8.0min by UHPLC-MS/MS. The method quantification limits (MQLs) for the 11 PPCPs ranged from 0.040 to 88ngL(-1) and from 0.030 to 90ngL(-1) for influent and effluent, respectively. The matrix effect was systematically investigated and quantified for different types of samples. The analysis of influent and effluent samples of two WWTPs in Hong Kong revealed the presence of 11 PPCPs, including acyclovir, benzophenone-3, benzylparaben, carbamazepine, ethylparaben, fluconazole, fluoxetine, methylparaben, metronidazole, propylparaben, and ranitidine. Their concentrations ranged from 9.1 to 1810ngL(-1) in influent and from 6.5 to 823ngL(-1) in effluent samples collected from Hong Kong WWTPs.

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36 patients were admitted during the study period Buy Amoxicillin Suspension Online . 4 of 31 (12.9%) of patients tested were antigen (+) on admission of which 2 (6.5%) were asymptomatic carriers and 2 (6.5%) had unsuspected active disease, including one with the BI epidemic strain. In follow-up, 20/36 (55.5%) developed diarrhea of which an additional 5 (13.8%) patients had developed CDI (average, hospital day 38) in the hospital. Therapy was instituted with vancomycin in 5/7 patients and metronidazole in 2/7 patients. During that quarter, the rate of nosocomial acquired CDI was 3.12 per 1000 patient days.

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Clostridium difficile toxins A and B, and C. perfringens enterotoxin were completely bound at dilutions of 1:2 to 1:16. Partial binding of C. difficile toxins occurred at dilutions up to 1:256 while partial binding of C. perfringens enterotoxin occurred up to a dilution of 1:128. Greater than 99% binding of endotoxin occurred with dilutions 1:2 to 1:32. No inhibition of growth of C. difficile or C. perfringens was present at any dilution, and there was no effect on the action of metronidazole.

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To determine the antibiotic susceptibility of Helicobacter pylori isolates from Israeli children; assess the role of previous antibiotic use in the development of antibiotic resistance and examine the possibility of simultaneous colonization of strains with different resistance patterns in the same patients.

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The CDI incidence was 11.2 and 12.7/10,000 patient-days in the EIA and PCR test periods, respectively (P = .36). Health care-associated CDI decreased from 4.4 per 10,000 patient-days during EIA testing to 0.9 per 10,000 patient-days during PCR testing (P = .02). A significant decrease in patient isolation-days (P < .00001), tests ordered (P = .002), and metronidazole treatment for patients with a negative C difficile test (P = .02) was observed with PCR testing.

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Oral therapy for patients with complicated intra-abdominal infections has been very limited because those patients are frequently ill and need surgery. In addition, at the time of diagnosis and initial treatment, the infection is often accompanied by ileus, gastrointestinal tract function is frequently unknown, and many patients cannot tolerate oral intake. The use of oral antimicrobials in this setting is a recent advance resulting from the availability of agents with good tissue pharmacokinetics and potent aerobic gram-negative activity. This is the first prospective blinded study of oral therapy to provide data on the characteristics of patients eligible for oral treatment and the consequences of such treatment.