It is only slightly bound to plasma proteins. Biotransformation is quite extensive, and parent drug and metabolites are excreted by both the renal and biliary routes. The principal clinical indications for metronidazole include the treatment of specific protozoal infections amebiasis, trichomoniasis, giardiasis, and balantidiasis and anaerobic bacterial infections such as those that may be seen in abdominal abscesses, peritonitis, empyema, genital tract infections, periodontitis, otitis media, osteitis, arthritis, and meningitis, and in necrotic tissue.
Metronidazole has been successfully used to prevent infection after colonic surgery. Nitroimidazoles also act as radiosensitizers, and metronidazole has been used as an adjunct to the radiotherapy of solid tumors. Adverse effects are not commonly associated with metronidazole. High doses may induce signs of neurotoxicity in dogs, such as tremors, muscle spasms, ataxia, and even convulsions. Reversible bone marrow depression has been reported. The drug should not be used in pregnant animals, particularly during the first trimester, although the evidence for carcinogenicity and mutagenicity is still tenuous.
Metronidazole may produce a reddish brown discoloration of the urine due to unidentified pigments. Courses of therapy are generally 5—7 days. Both PO and IV preparations are available. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The Veterinary Manual was first published in as a service to the community.
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Common Veterinary Topics. Videos Figures Images Quizzes. Antibacterial Agents. Test your knowledge. Dogs and cats with left-side congestive heart failure CHF can develop respiratory distress due to pulmonary edema.
Which of the following intravenous diuretics is the most appropriate treatment for life-threatening pulmonary edema caused by CHF? Metronidazole, the prototype nitroimidazole antimicrobial, was originally introduced to treat Trichomonas vaginalis, but is now used for the treatment of anaerobic and protozoal infections.
The nitroimidazoles are bactericidal through toxic metabolites which cause DNA strand breakage. Resistance, both clinical and microbiological, has been described only rarely.
The volume of distribution at steady state in adults is 0. Metronidazole is extensively metabolised by the liver to 5 metabolites. The pharmacokinetics of metronidazole are unaffected by acute or chronic renal failure, haemodialysis, continuous ambulatory peritoneal dialysis, age, pregnancy or enteric disease.
Renal dysfunction reduces the elimination of metronidazole metabolites; however, no toxicity has been documented and dosage alterations are unnecessary. Liver disease leads to a decreased clearance of metronidazole and dosage reduction is recommended.
Recent pharmacodynamic studies of metronidazole have demonstrated activity for 12 to 24 hours after administration of metronidazole 1 g.
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