DRUG CLASS AND MECHANISM

Metronidazole is an antibiotic effective against anaerobic bacteria and certain parasites. Anaerobic bacteria are single-celled, living organisms that thrive in environments in which there is little oxygen (anaerobic environments) and can cause disease in the abdomen (bacterial peritonitis), pelvis (ulcer of the ovaries and the Fallopian tubes) , liver (liver abscess). Giardia lamblia and ameba are intestinal parasites that can cause abdominal pain and diarrhoea in infected individuals. Trichomonas is a vaginal parasite that causes inflammation of the vagina (vaginitis). Metronidazole selectively blocks some of the functions within the bacterial cells and the parasites resulting in their death.

Indication of Metrogyl

Metronidazole is used to treat the following types of infections:- Certain types of bacterial infections.- Protozoal infections.- Pseudomembranous colitis. – Dental infections, including acute gingivitis.- Intra-abdominal infections.- Aspiration pneumonia.- Lung abscess.- Bacterial vaginosis.- Pelvic inflammatory disease.- Amoebiasis.- Eradication of helicobacter pylori bacteria, which is responsible for causing peptic ulcer disease.- Prevention of infections during and following surgery.

Action of Metrogyl

Metronidazole is thought to act by interfering with DNA synthesis in bacteria.

Dose advise of Metrogyl

Adults:- Oral dosing: 200-400 mg every 8-12 hours up to a maximum dose of 4 g daily.- Rectal dosing: 1 g every 8-12 hours.Children:- 5 mg/kg every 8 hours given orally or intravenously.- Rectal dosing: – Children aged 1-5 years: 250 mg 3 times a day.- Children aged 6-12 years: 500 mg, three times daily.For severe infections:-500 mg intravenously every 8-12 hours to a maximum dose of 4mg a day.Pseudomembranous colitis:- Adults: 400 mg orally three every 8 hours for 7-10 days.- Children: 10 mg/kg orally every 8 hours for 7-10 days.Surgical prophylaxis:Adults:- Intravenous infusion: 500 mg with the infusion ending at the time of induction.- Rectal dosing: 1 g given as a single dose 8 hours before surgery.- Oral dosing: 400 mg given as a single dose 1-2 hours before surgery.Children:- 12.5 mg/kg given intravenously to a maximum dose of 500 mg. The infusion should end at the time of induction Acute intestinal amoebiasis:- Adults: 600-800 mg orally every 8 hours for 6-10 days. – Children: 15 mg/kg orally every 8 hours to a maximum dose of 800 mg every 8 hours given for 6-10 days. The treatment course can be repeated after two weeks if necessary. Extra-intestinal amoebiasis:- Adults: 600-800 mg orally every 8 hours for 10-14 days. – Children: 15 mg/kg orally every 8 hours to a maximum dose of 800 mg every 8 hours given for 10-14 days. Bacterial vaginosis:- 400 mg orally twice a day for five days.Trichomoniasis:-2 g orally given as a single dose. If this fails, 400 mg should be given twice daily for five days. – In women who are pregnant or lactating the 5-day course should be used.- Sexual partners also need to be treated. Giardiasis:- Adults: 2 g orally for three days. If this fails, 400 mg should be given every 8 hours for seven days.- Children: 30 mg/kg up to a maximum of 2g given orally once a day for three days or, if this fails, 10 mg/kg should be given three times a day for seven days.