METRONIDAZOLE - DRUG OF MANY INDICATIONS.

Metronidazole (MTZ) is one of the basic medications used in the therapy of anaerobic and microaerophilic bacterial infections and a mainstay drug in protozoal infections. MTZ was initially used only against parasites. Later was found excellent benefit against anaerobic bacteria. Nowadays, MTZ is a generally accepted and widely used as an antimicrobial in the therapy of a wide range of infections extending from amoebiasis to bacterial septicaemia. Nitroimidazoles, one of which is metronidazole, have been known for their large spectrum of activity as well as their low incidence of resistance for already more than 55 years. However, as with nearly all antibacterial drugs, resistances are on the rise and susceptibility testing is of special interest. MTZ is a bactericidal drug that works via a four-step process that finally leads to the death of the microorganism by damaging the host cell's DNA. Furthermore, there are common resistant strains depicted in this paper and the mechanism behind the resistance is then discussed. Clinical indications are illustrated, using dosing regimens and examples, to give clear advice on when and how to use metronidazole. MTZs use in Helicobacter pylori eradication and Clostridium difficile infections is nowadays still considered essential even though other possibilities do exist. Besides the bacterial indications, MTZ is also used in protozoal infections by Trichomonas vaginalis, Giardia lamblia and Entamoeba histolytica. [ABSTRACT FROM AUTHOR]