Relief of pain after surgery of benign anorectal conditions: topical versus oral metronidazole

Clostridum difficile—associated disease (CDAD) is the leading cause of infectious diarrhea and is associated with considerable morbidity and mortality. The incidence is estimated to range from 3.4 to 8.4 cases per 1000 hospital admissions, and it has become a growing problem at many institutions. Treatment options for CDAD are limited due to a paucity of new pharmacologic agents and studies examining other potential treatments. Historically oral metronidazole and oral vancomycin have been used as first-line agents in the treating CDAD, however recent reports of treatment failure and recurrence with these agents have surfaced. These reports illustrate a need for novel pharmacologic agents and a thorough review of currently available agents that may have activity against C difficile. Available data on the treatment of CDAD were extracted and reviewed to outline the appropriate management of CDAD.

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Efficacy of Oral Metronidazole and Potassium Sorbate Against Two Gregarine Parasites, Protomagalhaensia granulosae and Gregarina cubensis (Apicomplexa: Eugregarinida), Infecting the Death's Head Cockroach, Blaberus discoidalis

Comparative Parasitology ◽

10.1654/4109 ◽

2003 ◽

Vol 70 (2) ◽

pp. 196-199 ◽

Cited By ~ 6

Author(s):

Autumn J. Smith ◽

R. E. Clopton

Keyword(s):

Potassium Sorbate ◽

Blaberus Discoidalis ◽

Oral Metronidazole

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Penetration of Metronidazole into Continuous Ambulatory Peritoneal Dialysate

Peritoneal Dialysis International ◽

10.1177/089686088300300403 ◽

1983 ◽

Vol 3 (4) ◽

pp. 173-174

Author(s):

Andrew Bush ◽

Jacquelyn E. Holt ◽

Michael G. Sankey ◽

Clive M. Kaye ◽

Roger Gabriel

Keyword(s):

High Performance ◽

Chromatographic Method ◽

Inhibitory Concentration ◽

Anaerobic Bacteria ◽

High Performance Liquid Chromatographic ◽

Peritoneal Dialysate ◽

Liquid Chromatographic Method ◽

Oxidative Metabolites ◽

Liquid Chromatographic ◽

Oral Metronidazole

Seven patients receiving continuous ambulatory peritoneal dialysis were given 400 mg of oral metronidazole every eight hours for three days. Plasma, dialysate and urine were collected during the final 24 hours and assayed for metronidazole and its two principal oxidative metabolites by a specific, high-performance, liquid-chromatographic method. Concentrations of metronidazole in plasma and dialysate were similar and were greater than the minimum inhibitory concentration for susceptible anaerobes. There was evidence of retention of both oxidative metabolites. This study shows that oral metronidazole in standard dosages achieves bactericidal concentrations in peritoneal fluid and should be effective in the treatment of peritonitis due to anaerobic bacteria.

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Prognostic Indicators of Recurrence of Bacterial Vaginosis

Journal of Clinical Microbiology ◽

10.1128/jcm.00227-19 ◽

2019 ◽

Vol 57 (5) ◽

Cited By ~ 3

Author(s):

Jack D. Sobel ◽

Navkiranjot Kaur ◽

Nicole A. Woznicki ◽

Dina Boikov ◽

Tina Aguin ◽

...

Keyword(s):

Bacterial Vaginosis ◽

Prognostic Value ◽

Prognostic Indicators ◽

Recurrence Rates ◽

Predictive Values ◽

Prognostic Tests ◽

Index Tests ◽

Treatment Alternatives ◽

Cessation Of Treatment ◽

Oral Metronidazole

ABSTRACTFollowing all forms of therapy for bacterial vaginosis (BV), recurrence rates are extremely high. Many diagnostic tests are available that differentiate bacterial vaginosis from other types of vaginal disorders, but none predict recurrence after treatment, nor are any vetted for monitoring ongoing responses to treatment. Our goal was to determine which tests, and at what optimal times, have prognostic value in predicting recurrence. This prospective cohort study monitored 74 highly recurrent BV patients for up to 9 months. Symptomatic BV patients were treated with oral metronidazole and were evaluated at cessation of treatment and monthly. Index tests included Amsel, Nugent, BV Blue, and Affirm VPIII, as well as a quantitative PCR (qPCR)-based test under initial evaluation here. The qPCR-based LbRC (LactobacillusRelativeComposition) assay predicted BV recurrence when performed shortly after oral metronidazole treatment, with both 90% positive predictive values (PPV) and 74% negative predictive values (NPV); the Nugent scores had 93% PPV but poor NPV (57%). No test, at any other visit, was prognostic. The LbRC assay and, to a lesser extent, Nugent tests scored a week after oral metronidiazole predicted recurrence, suggesting that the recurrence in this cohort was predominantly by relapse due to incomplete restoration of eubiosis soon after therapy. This is the first study in an under evaluated population of recurrent BV patients that emphasizes the need for and a pathway to a possible prognostic modality. Given the high recurrence rates of BV, prognostic tests that could influence individualized treatment alternatives are urgently needed.

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Oral metronidazole in Clostridium difficile colitis.

BMJ ◽

10.1136/bmj.2.6185.335-c ◽

1979 ◽

Vol 2 (6185) ◽

pp. 335-335 ◽

Cited By ~ 13

Author(s):

G A Mogg ◽

D W Burdon ◽

M Keighley

Keyword(s):

Clostridium Difficile ◽

Clostridium Difficile Colitis ◽

Oral Metronidazole

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A Double-Blind Placebo-Controlled Trial of Single-Dose Intravaginal versus Single-Dose Oral Metronidazole in the Treatment of Trichomonal Vaginitis

The Journal of Infectious Diseases ◽

10.1093/infdis/170.1.242 ◽

1994 ◽

Vol 170 (1) ◽

pp. 242-246 ◽

Cited By ~ 20

Author(s):

B. H. Tidwell ◽

W. B. Lushbaugh ◽

M. D. Laughlin ◽

J. D. Cleary ◽

R. W. Finley

Keyword(s):

Single Dose ◽

Controlled Trial ◽

Double Blind ◽

Double Blind Placebo ◽

Dose Oral ◽

Oral Metronidazole

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