Metronidazole

Metronidazole

Answer. Metronidazole is a nitroimidazole compound.

• Metronidazole is used to treat protozoal infections.
• Metronidazole is bactericidal to anaerobic organisms.

Metronidazole Clinical Indications

• Metronidazole is not the drug for treating A. actinomycetemcomitans infections, but it can be effective at therapeutic levels due to its hydroxyl metabolite. So metronidazole when used in combination with other antibiotics, it becomes effective against A. actinomycetemcomitans.
• Metronidazole  is also effective against anaerobes such as Porphyromonas gingivalis and Prevotella intermedia.
• Metronidazole  has been used to treat gingivitis, ANUG, chronic periodontitis and aggressive periodontitis.
• Single dose of metronidazole (250 mg orally) appears in both serum and gingival crevicular fluid in sufficient quantities to inhibit a wide range of suspected periodontal pathogens.
• When metronidazole is administered systemically (750-1000 mg/ day for two weeks), it decreases the growth of anaerobic microorganisms, including spirochetes, and decreases the clinical as well as histopathological signs of periodontitis.
• Most common regimen for metronidazole is 250 mg three times daily for a week.
• Metronidazole  used as a supplement to rigorous scaling and root planning which result in a significantly reduced need for surgery compared with root planning alone.

Subgingival Metronidazole

• A topical medication containing an oil-based metronidazole 25% dental gel (glyceryl monooleate and sesame oil) has been tested in a number of studies.
• As a precursor, the preparation contains metronidazole benzoate, which is converted into the active substance by esterases in the gingival crevicular fluid.
• Two times the 25% gel applications at a one week interval have been used.

Side Effects of Metronidazole

• The drug has an anti-abuse effect when alcohol is ingested, resulting in severe cramps, nausea and vomiting. Hence, products containing alcohol should be avoided at the time of metronidazole therapy and for at least 1 day after therapy is discontinued.
• Metronidazole inhibits warfarin metabolism.
• Patients undergoing anticoagulant therapy should avoid metronidazole as it prolongs prothrombin time.
• Metronidazole  also should be avoided in patients who are taking lithium.