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Metrogyl (Flagyl)
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Metrogyl

Metrogyl is used to treat bacterial infections in different areas of the body. The extended-release tablets are used to treat women with vaginal infections (bacterial vaginosis).

Other names for this medication:
Acuzole, Amodis, Amrizole, Anazol, Aristogyl, Bemetrazole, Birodogyl, Diazole, Dumozol, Elyzol, Entizol, Etron, Filmet, Flagenase, Flagyl, Flagystatin, Flazol, Gynotran, Klion, Medazol, Metazol, Metrazol, Metris, Metrocream, Metrogel, Metrolag, Metrolotion, Metronidazol, Metronidazole, Metronide, Metropast, Metrosa, Metrovax, Metrozine, Negazole, Nidagel, Nidazol, Nidazole, Nizole, Noritate, Onida, Orvagil, Protogyl, Rhodogil, Riazole, Rodogyl, Rozex, Stomorgyl, Supplin, Trichazole, Triconex, Trogyl, Vagilen, Vandazole, Vertisal, Zidoval

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Amoxil, Bactrim, Ampicillin, Augmentin, Macrobid, Trimox, Tinidazole, Biaxin, Chloromycetin, Myambutol

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Also known as:  Flagyl.

Description

Metrogyl (generic name: Metronidazole) is an antibiotic that belongs to a group of medicines called nitroimidazoles.

Metrogyl is used for the treatment of susceptible anaerobic bacterial and protozoal infections in the following conditions: amebiasis, symptomatic and asymptomatic trichomoniasis; skin and skin structure infections; CNS infections; intra-abdominal infections (as part of combination regimen); systemic anaerobic infections; treatment of antibiotic-associated pseudomembranous colitis (AAPC); bacterial vaginosis; as part of a multidrug regimen for H. pylori eradication to reduce the risk of duodenal ulcer recurrence.

Dosage

Metrogyl 250-mg tablets are round, blue, film coated, with SEARLE and 1831 debossed on one side and Metrogyl and 250 on the other side; bottles of 50, 100, and 2,500. Metrogyl 500-mg tablets are oblong, blue, film coated, with Metrogyl debossed on one side and 500 on the other side; bottles of 50, 100, and 500.

Overdose

In cases of overdose in adults, the clinical symptoms are usually limited to nausea, vomiting, ataxia and slight disorientation. In a preterm newborn, no clinical or biological sign of toxicity developed.

There is no specific treatment for Metrogyl overdose, Metrogyl infusion should be discontinued. Patients should be treated symptomatically.

Storage

Store at room temperature below 25 degrees C (77 degrees F) away from moisture, light and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Metrogyl are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

To reduce the development of drug-resistant bac- teria and maintain the effectiveness of Metrogyl and other antibacterial drugs, Metrogyl should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

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The aim of this study was to determine the in vitro activity of clarithromycin and metronidazole using an agar dilution method to compare two different incubation atmospheres: a CO2 incubator and a jar with a microaerobic gas-generating system. Antibiotics were placed on plates in twofold dilutions ranging from 128 to 0.064 mg/l in Mueller-Hinton agar supplemented with 7% horse blood. The inoculum was prepared from 31 Helicobacter pylori isolates and was inoculated using a Steers replicator. Plates were incubated for 3 to 5 days and MICs were recorded as the lowest concentration of antibiotic inhibiting visible growth. Two different incubation atmospheres were used: a CO2 incubator set at 95% humidity and 10% CO2, and a jar with a gas-generating envelope that produces 7-10% O2 and 14% CO2 (BioMerieux). Clarithromycin resistance was found in 19% of strains both in the gas-generating system and the CO2 incubator. Metronidazole resistance was 23% in both atmospheres. MICs for clarithromycin in both atmospheres showed two dilutions of difference for 100% of the strains, and were slightly higher in the jar with a gas-generating envelope. However, MICs for metronidazole were higher when it was incubated in the CO2 incubator, and in 86.7% of strains the MICs showed < or = 2 dilutions of difference. No great discrepancies were found for either metronidazole or clarithromycin using the two methods.

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Incidence and treatment in our Medical Center and elsewhere.

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Because of the insufficient quantity and heterogenecity of studies, no adequate evidence could be gathered to use the beneficial effects of these antibiotics along with SRP in aggressive periodontitis compared with SRP alone.

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The advent of biological therapies has focused attention on the importance of healing luminal Crohn's disease, thereby modifying the disease course. Perianal fistulas are common in Crohn's disease and often have a poor prognosis, with permanent sphincter and perineal tissue destruction. The importance of healing these fistulas has been less well appreciated. Management still often is left in surgical hands alone, rather than the optimal combination of surgery, infection control, and immunosuppression. Drug therapy often is haphazard, and the means of assessing healing over a long time period has been characterized poorly. Recent studies have suggested that many of these patients can achieve fistula healing, at least in the medium term. We therefore call for more active intervention, with the goal of healing, in these sick patients. Perianal fistulas lead to substantial physical and emotional distress because of pain, discharge, incontinence, perineal and genital disfigurement, and slow resolution even with treatment. The advent of accurate anal imaging, improved knowledge of surgical outcomes, and potent biological therapies make it timely to reflect on current best-management strategies.

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Metronidazole is an antiprotozoal agent used in the treatment of bacterial and protozoal anaerobic infections. The objectives of this study were to develop concentrated metronidazole suspensions that are inexpensive and easy to prepare and determine the stability of these suspensions after storage in amber polyvinyl chloride bottles at room temperature (23°C) and under refrigeration (5°C). Metronidazole suspensions (50 mg/mL) were prepared from powder using Ora-Blend or simple syrup as the vehicles. Samples were collected in triplicate from each container on days 0, 7, 14, 28, 56, and 93. Samples were assayed using a high-performance liquid chromatography method that had been validated as stability indicating. Color, change in physical appearance, and pH were also monitored at each time interval. There was no apparent change in color or physical appearance. The pH values changed by less than 0.20 units over the 93 days. The stability of metronidazole suspensions compounded from United States Pharmacopeia powder using Ora-Blend or simple syrup and packaged in amber polyvinyl chloride bottles was determined to be 93 days when stored at either room temperature or under refrigeration.

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Antibiotic-resistant Helicobacter pylori strains are becoming increasingly prevalent, although it is not clear to what extent the new resistant organisms will spread.

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Eradication of H pylori infection is recommended in (a) patients with gastroduodenal diseases such as peptic ulcer disease and low grade gastric, mucosa associated lymphoid tissue (MALT) lymphoma; (b) patients with atrophic gastritis; (c) first degree relatives of patients with gastric cancer; (d) patients with unexplained iron deficiency anaemia; and (e) patients with chronic idiopathic thrombocytopenic purpura. Recurrent abdominal pain in children is not an indication for a "test and treat" strategy if other causes are excluded. Eradication of H pylori infection (a) does not cause gastro-oesophageal reflux disease (GORD) or exacerbate GORD, and (b) may prevent peptic ulcer in patients who are naïve users of non-steroidal anti-inflammatory drugs (NSAIDs). H pylori eradication is less effective than proton pump inhibitor (PPI) treatment in preventing ulcer recurrence in long term NSAID users. In primary care a test and treat strategy using a non-invasive test is recommended in adult patients with persistent dyspepsia under the age of 45. The urea breath test, stool antigen tests, and serological kits with a high accuracy are non-invasive tests which should be used for the diagnosis of H pylori infection. Triple therapy using a PPI with clarithromycin and amoxicillin or metronidazole given twice daily remains the recommended first choice treatment. Bismuth-containing quadruple therapy, if available, is also a first choice treatment option. Rescue treatment should be based on antimicrobial susceptibility.

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The administration of indometacin to rats increases intestinal permeability and induces inflammatory pathology of the small bowel. This represents a potential model for Crohn's disease.

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We enrolled 41 patients in whom first-line treatment with LAC (lansoprazole, amoxycillin and clarithromycin) was unsuccessful. Endoscopic biopsied specimens were used to examine antibiotic susceptibility to clarithromycin by dilution agar methods. PCR-RFLP analysis was performed to determine the presence of point mutations, which are primarily responsible for resistance to clarithromycin.

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Delivery of amoxycillin across the human gastric mucosa to Helicobacter pylori is poor compared with that of metronidazole and clarithromycin, limiting the clinical effectiveness of this penicillin. To investigate the physicochemical properties of penicillins that influence their flux across gastric mucosa, the fluxes of metronidazole and eight penicillins were measured in vitro across rat gastric mucosa. The lipophilicity of these drugs was also measured using potentiometric titration. The mean fluxes of monobasic penicillins (range 0.66-0.89 nmol/cm2/h) were significantly lower than those of the aminopenicillins (range 1.94-2.80 nmol/cm2/h) (P < 0.005). Penicillin flux was not significantly correlated with lipophilicity as measured, but was significantly correlated with published protein binding data (rs = 0.9048, P < 0.002). Metronidazole flux was significantly higher than that of any penicillin at 22.6 (+/-0.9) nmol/cm2/h (P < 0.001). Therefore, the in-vitro gastric delivery of penicillins can be predicted from protein binding which may in turn predict activity against H. pylori in vivo.

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To survey the antibiotic susceptibility patterns of some commercially available Lactobacillus, we collected four commercial products that contain active Lactobacillus. We incubated individual product and identified these colonies by the methods of API50 CH test kit and RAPID ID 32A kit. Strains of Streptococcus thermophilus, Bifidobacterium infantis, Lactobacillus acidophilus and Lactobacillus casei were collected. By agar dilution method, each identified strain was inoculated to Brucella blood agar-MIC plates. Each plate contained one of the following antibiotics with different concentrations: amoxicillin, cephalothin, gentamicin, vancomycin, erythromycin, rifampin, tetracyclin and penicillin G, clindamycin, chloramphenicol, cefmetazole, metronidazole, ampicillin/sulbactum, cefoxtin, etc. After incubation, the growth condition of each Brucella blood agar-MIC plate was observed and the breakpoint of each antibiotic to different Lactobacillus products determined. The MICs of amoxicillin, ampicillin/sulbactum and penicillin-G to all identified strains were < or =2 microg/ml and those of vancomycin, clindamycin, erythromycin, metronidazole, cefmetazole and cefoxtin for L. casei were >32 microg/ml. L. casei was more resistant to all the testing antibiotics than the other strains. According to the MICs of the above antibiotics, proper active lactobacillus products could be chosen to prevent antibiotic-associated diarrhea in the pediatric field.

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metrogyl renal dose 2017-02-15

The emergence of antimicrobial resistance among Campylobacter isolates recovered from turkeys has increased dramatically. Monitoring the progress of this resistance becomes a growing public health issue. The aim of the present study was to provide information of the current status of antibiotic resistance patterns in Campylobacter jejuni from turkeys. Seventy-six C. jejuni isolates were recovered from 67 epidemiologically unrelated meat turkey flocks in different regions of Germany in 2010 and 2011. The isolates were typed by flaA genotyping and were investigated for antimicrobial susceptibility against 12 antibiotics by using a broth microdilution test as well as testing the genetic determination of ciprofloxacin, tetracycline, and erythromycin resistance. All isolates (n = 76) were sensitive to gentamicin and chloramphenicol. The numbers of isolates that were sensitive to streptomycin, erythromycin, neomycin, and amoxicillin were 69 (90. Bactrim Dosing Peds 8%), 61 (80.2%), 58 (76.4%), and 44 (57.9%), respectively. Only one isolate was sensitive to all tested antibiotics. The emergence of a high resistance rate and multidrug resistance to three or more classes of antimicrobial agents were observed. The resistance against sulphamethoxazole/trimethoprim, metronidazole, ciprofloxacin, naladixic acid, and tetracycline was 58 (76.3%), 58 (76.3%), 53 (69.7%), 51 (67.1%), and 42 (55.3%), respectively. None of the isolates was resistant to all antibiotics. Multidrug resistance to three or more classes of antimicrobial agents was found and ranged from 3.9% to 40.8%. Replacement of the Thr-86-->Ile in gyrA gene and detection of the tet(O) gene were the main resistance mechanisms for fluoroquinolones and tetracycline, respectively, while the lack of mutation in position 2074 and 2075 on the 23S rRNA gene was responsible for macrolide resistance. The phenotypic and genotypic resistance profiles were compatible in the case of ciprofloxacin and tetracycline but were not completely congruent with respect to erythromycin.

metrogyl dg gel forte uses 2017-09-21

This retrospective study included 18 GAP subjects who received a conventional course of full- Himox Tablet mouth non-surgical periodontal treatment using machine-driven and hand instruments and an adjunctive course of systemic antibiotics (500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days). Clinical parameters were collected at baseline and at 2 months post-treatment. Self-reported adherence to the prescribed medication regimen was recorded at 2 months.

metrogyl 400 mg during pregnancy 2017-05-18

Metronidazole-induced encephalopathy is an uncommon but potentially reversible disease in Trimol 160 Mg patients with acute neurological deficits from the use of metronidazole. Nonalcoholic Wernicke's encephalopathy may share a similar metabolic pathway with MIE, resulting in difficulties in diagnosis.

metrogyl denta gel 2015-07-19

Over the past two decades there has been a dramatic increase worldwide in both incidence and severity of Clostridium difficile infection (CDI). Paralleling the rising incidence of CDI in the general population, there has been an even higher increase in the incidence of CDI among patients with inflammatory bowel disease (IBD). CDI may mimic a flare of IBD as symptoms and laboratory parameters are often similar, and therefore, screening for CDI is recommended at every flare in such patients. Enzyme immunoassay to detect Clostridium difficile toxin A and B in stool is still the most widely used test for CDI diagnosis despite its low sensitivity. Metronidazole for mild/moderate CDI,and vancomycin for severe CDI are the preferred agents for the treatment of infection. CDI has a negative impact both on short- and long- term IBD outcomes, increasing the need for surgery, as well as the mortality rate and healthcare costs. All gastroenterologists and surgeons should have a high index of suspicion for CDI when evaluating a patient with IBD flare, as prompt diagnosis and adequate treatment of Purbac With Alcohol infection improve outcomes. Measures must be taken to prevent spreading of infection in gastroenterology /surgery settings.

metrogyl 200 mg tablets side effects 2015-03-06

The aim of this study was to confirm a presumptive qualification of clinical B. fragilis group strains isolated in Płock as ESBL-positive strains and to determine some properties of these strains. Twenty four clinical strains belonging to the B. fragilis group, isolated first of all from surgical patients, were received for testing. Identification of strains was performed in the automatic ATB Expression system (bioMerieux sa, France) using biochemical API 20 A strips. Strains were tested for the production of catalase (ID Color Catalase test, bioMerieux sa) and beta-lactamase (Cefinase, BBL, Becton Dickinson, USA). Susceptibility Amoxoral 500 Mg Voor Honden Bijwerkingen of strains to four antimicrobial agents: clindamycin, metronidazole, amoxicillin/clavulanic acid and imipenem was determined by Etest (AB Biodisk, Sweden). ESBLs were detected with the use of two disc diffusion methods: the double-disc synergy test (DDST) according to Jarlier et al. and the diagnostic disc (DD) test according to Appleton. Seventeen of examined strains belonged to the species Bacteroides fragilis, three--to B. ovatus/thetaiotaomicron, two--to B. distasonis, one--to B. uniformis and one--to B. stercoris/eggerthii. One strain (B. uniformis) did not produce catalase, whereas all strains produced beta-lactamases. Examined strains were susceptible in vitro to metronidazole, amoxicillin/clavulanic acid and imipenem. One clindamycin-resistant strain was detected (B. fragilis). Occurrence of ESBL-type enzymes was confirmed in 22 strains of following species: B. fragilis (17 strains), B. ovatus/thetaiotaomicron (3), B. distasonis (1) and B. uniformis (1). Clinical strains of the B. fragilis group with a new mechanism of resistance to beta-lactam antibiotics appeared during last years in Poland. They produce extended-spectrum beta-lactamases (ESBLs), so they are resistant to penicillins, cephalosporins and monobactams. Monitoring of infections caused by these threatening strains in hospital patients is very important.

metrogyl tablets uses 2017-04-11

Seven subjects abandoned the study; at 12 months the M+A group had 20 subjects and the placebo group 19. There were Erythromycin Cost Without Insurance no significant differences in the clinical parameters at baseline between the 2 groups. After 2 months and thereafter, the M+A group showed significant clinical improvement while the placebo group showed a progressive deterioration of periodontal status. At 12 months compared to baseline, subjects of the M+A group showed: 1) a significant overall mean attachment gain of 0.43 mm (P = 0.005); 2) a significant decrease of active sites (P< or =0.03); 3) a significant increase of sites gaining attachment level (P< or =0.01); 4) a significant reduction of pocket depth (P< or =0.00006); and 5) a significant decrease in percentage of bleeding on probing sites (BOP) (P< or =0.0005). Significant differences between both groups at all 2-month evaluations were found in overall mean attachment level (P < or =0.000004), in percent of active sites (P< or =0.03), and in percent of BOP sites (P< or =0.02). Sites exhibiting > or =2 mm of attachment loss in 2 successive or alternate evaluations, and periodontal abscess were noticed only in the placebo group.

metrogyl gel plus ornidazole gel 2015-11-03

Retrospective chart review of 200 confirmed cases Karin Slaughter Book In Order of peritonsillar abscess.

metrogyl medicine 2017-09-04

The study enrolled 50 subjects (age: 53.1+/-7; 23 men and 27 women) diagnosed with moderate or severe essential hypertension. Patient clinical characteristics were as follows: 80% had hypercholesterolemia, 72% were obese/overweight, 6% had diabetes mellitus, 16% were current smokers, 40% had target organ damage, and the overall general dental health status was poor. CRP and fibrinogen levels were assessed prior to treatment and again after 6 months. Dental treatment was mainly for periodontal disease and dental caries and its complications, and consisted of extractions of hopeless teeth, supragingival scaling, subgingival curettage, anti-inflammatory rinses and metronidazole treatment. There was a mean 4 treatment sessions per patient over 11 weeks. Amoclane Eg En Alcohol

metrogyl gel dental use 2016-02-28

Despite continuous improvement of Helicobacter pylori (Hp) eradication therapy, new treatment regimens are necessary if established first-line Amrizole Syrup Dose treatments fail. In the present pilot study, a recently described rifabutin-based triple therapy was evaluated after preceding failure of triple therapy. Rifabutin (150 mg), amoxicillin (1 g), and lansoprazole (30 mg) were administered twice daily for 1 week to 25 patients infected with Hp who had previously failed to respond to eradication treatment and/or who had developed resistance to macrolides and nitroimidazoles. Four patients were lost to follow-up. Eradication rate of rifabutin-based triple therapy was 86% (18/21; per protocol) and 72% (18/25; intention-to-treat). Side effects were minimal. It is concluded that this new drug combination is an effective therapy for Hp strains resistant to clarithromycin or metronidazole; however, rifabutin-based treatment regimens for Hp eradication should be restricted to patients infected with resistant strains.

metrogyl gel 30g 2015-04-23

To investigate metronidazole resistance and the prevalence of Cefuroxime 100 Mg nitroimidazole (nim) genes in clinically isolated anaerobic Gram-positive cocci.

metrogyl 200 mg tablets uses 2015-04-22

We describe a case of a young returning traveller who contracted amoebic dysentery while visiting India. She presented to a major London Hospital several months later with features suggestive of amoebic liver abscesses, a known sequelae of amoebiasis. MRI with intravenous contrast demonstrated an area of likely occlusion of the portal vein. The patient was treated with intravenous metronidazole for 10 days followed by diloxanide furoate, an intraluminal agent. The largest abscess was drained Bactrim 200 Mg acutely under ultrasound guidance. The portal vein occlusion was treated medically without the use of anticoagulation. A repeat ultrasound at 6 weeks post-treatment confirmed patency of the portal vein indicating spontaneous recanalisation with antimicrobial therapy alone.