Journal Article

Metronidazole Is Still the Drug of Choice for Treatment of Anaerobic Infections

Sonja Löfmark, Charlotta Edlund and Carl Erik Nord

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 50, issue Supplement_1, pages S16-S23
Published in print February 2010 | ISSN: 1058-4838
Published online February 2010 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/647939
Metronidazole Is Still the Drug of Choice for Treatment of Anaerobic Infections

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Metronidazole has been used for the treatment of infections for >45 years and is still successfully used for the treatment of trichomoniasis, amoebiasis, and giardiasis. Anaerobic bacterial infections caused by Bacteroides species, fusobacteria, and clostridia respond favorably to metronidazole therapy. Good clinical results in the treatment of vaginosis due to Gardnerella vaginalis have also been reported. Rates of resistance to metronidazole are still generally low; however, several studies have reported decreased susceptibility among Bacteroides species, as well as different mechanisms of resistance. Metronidazole-resistant Helicobacter pylori strains have been described, but combination therapy (eg, metronidazole, amoxicillin, or clarithromycin plus omeprazole) is still recommended for eradication of this pathogen in patients with gastroduodenal ulcers. Metronidazole is considered to be a cost-effective drug because of its low cost, good activity against pathogenic anaerobic bacteria, favorable pharmacokinetic and pharmacodynamic properties, and minor adverse effects. Metronidazole is still the criterion standard for therapy of anaerobic infections, as was described by Tally and colleagues 35 years ago.

Journal Article.  5158 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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