Metronidazole

Question 1

What bacteria are targeted by Metronidazole?

Answer 1

Anaerobes

Question 2

Mechanism of Action of Metronidazole

Answer 2

Inhibits DNA Synthesis
Prodrug that is activated by metabolism
Selectively target anaerobic bacteria with ferridoxin enzymes that are used to donate electrons

Question 3

Metronidazole Resistance

Answer 3

Fairly uncommon; altered growth requirements or ferridoxin levels may confer resistance

Question 4

Metronidazole Spectrum of Activity

Answer 4

Anaerobes (like Bacteroides or Clostridium spp)

Question 5

Metronidazole Pharmacokinetics (ADME)

Answer 5

Almost 100% absorbed orally.
Wide distribution to tissues and good penetration of CSF
Metabolized and eliminated by liver

Question 6

Clinical Uses of Metronidazole

Answer 6

Anaerobic infections (intra-abdominal, pelvic, diabetic foot and decubitis ulcers, brain abscess)
Pseudomembrane colitis due to C diff.

Question 7

Metronidazole Side Effects

Answer 7

GI side effects most common - Nausea, stomatitis, metallic taste
CNS- peripheral neuropathy with prolonged use

AVOID during pregnancy and breastfeeding

Question 8

Metronidazole Drug Interactions

Answer 8

Warfarin- Increase anticoagulant activity

Alcohol- Disulfram raction