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Metronidazol (Flagyl)
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Metronidazol

Metronidazol belongs to the class of medicines known as antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.

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, Metrogyl, Metrolag, Metrolotion, 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

Similar Products:
Amoxil, Bactrim, Ampicillin, Augmentin, Macrobid, Trimox, Tinidazole, Biaxin, Chloromycetin, Myambutol

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Also known as:  Flagyl.

Description

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

Metronidazol 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

The dosage regimen should be individualized. Single-dose treatment can assure compliance, especially if administered under supervision, in those patients who cannot be relied on to con- tinue the seven-day regimen. A seven-day course of treatment may minimize reinfection by pro- tecting the patient long enough for the sexual con- tacts to obtain appropriate treatment. Further, some patients may tolerate one treatment regi- men better than the other.

Overdose

Single oral doses of Metronidazol, up to 15 g, have been reported in suicide attempts and accidental overdoses. Symptoms reported include nausea, vomiting, and ataxia. Oral Metronidazol has been studied as a radiation sensitizer in the treatment of malignant tumors. Neurotoxic effects, including seizures and peripheral neuropathy, have been reported after 5 to 7 days of doses of 6 to 10.4 g every other day.

There is no specific antidote for Metronidazol overdose; therefore, management of the patient should consist of symptomatic and supportive therapy.

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 Metronidazol 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 Metronidazol and other antibacterial drugs, Metronidazol should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

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1. Acute Encephalopathy in Cirrhosis A. GENERAL MEASURES. Tracheal intubation in patients with deep encephalopathy should be considered. A nasogastric tube is placed for patients in deep encephalopathy. Avoid sedatives whenever possible. Correction of the precipitating factor is the most important measure. B. SPECIFIC MEASURES i. Nutrition. In case of deep encephalopathy, oral intake is withheld for 24-48 h and i.v. glucose is provided until improvement. Enteral nutrition can be started if the patient appears unable to eat after this period. Protein intake begins at a dose of 0.5 g/kg/day, with progressive increase to 1-1.5 g/kg/day. ii. Lactulose is administered via enema or nasogastric tube in deep encephalopathy. The oral route is optimized by dosing every hour until stool evacuation appears. Lactulose can be replaced by oral neomycin. iii. Flumazenil may be used in selected cases of suspected benzodiazepine use. 2. Chronic Encephalopathy in Cirrhosis i. Avoidance and prevention of precipitating factors, including the institution of prophylactic measures. ii. Nutrition. Improve protein intake by feeding dairy products and vegetable-based diets. Oral branched-chain amino acids can be considered for individuals intolerant of all protein. iii. Lactulose. Dosing aims at two to three soft bowel movements per day. Antibiotics are reserved for patients who respond poorly to disaccharides or who do not exhibit diarrhea or acidification of the stool. Chronic antibiotic use (neomycin, metronidazole) requires careful renal, neurological, and/or otological monitoring. iv. Refer for liver transplantation in appropriate candidates. For problematic encephalopathy (nonresponsive to therapy), consider imaging of splanchnic vessels to identify large spontaneous portal-systemic shunts potentially amenable to radiological occlusion. In addition, consider the combination of lactulose and neomycin, addition of oral zinc, and invasive approaches, such as occlusion of TIPS or surgical shunts, if present. Minimal or Subclinical Encephalopathy Treatment can be instituted in selected cases. The most characteristic neuropsychological deficits in patients with cirrhosis are in motor and attentional skills (60). Although these may impact the ability to perform daily activities, many subjects can compensate for these defects. Recent studies suggest a small but significant impact of these abnormalities on patients' quality of life (61), including difficulties with sleep (62). In patients with significant deficits or complaints, a therapeutic program based on dietary manipulations and/or nonabsorbable disaccharides may be tried. Benzodiazepines should not be used for patients with sleep difficulties.

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The EAL regimen can achieve an efficacy similar to that of the standard EBTM therapy. It may be very useful in countries where bismuth salts are not available. Compliance, CYP2C19 genotype and resistances to antibiotics may influence the outcome of levofloxacin-based rescue therapy. It seems advisable to reserve levofloxacin for rescue treatment to avoid an increase in the resistance phenomenon.

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High quality evidence shows that antibiotic treatment for sexual partners of women with BV, compared with placebo, does not increase the rate of clinical or symptomatic improvement during the first, between the first and fourth or after the fourth week into the women. Low quality evidence suggests that antibiotic treatment does not led to a lower recurrence rate during the first and fourth or after the fourth week of treatment into the women, but increases the frequency of adverse events reported by sexual partners. Finally, compared with no intervention, antibiotic treatment does not decrease the recurrence rate after the fourth week and does not increase the frequency of clinical or symptomatic improvement between the first and fourth or after the fourth week into the women, respectively.

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The eradication rate was 87.1% (169/194, intention to treat [ITT]) in the OAM group and 77% (137/ 178, ITT) in the RAM group. The difference of 10.1% (95% CI 2.5-18%) is statistically significant (P= 0.0104). The ulcer healing rate was 93.3% in the OAM group (181/194, ITT) and 92.1% in the RAM group (164/178, ITT, NS). With regard to the speed and intensity of pain reduction, the OAM group was superior to the RAM group. In patients in whom H. pylori eradication was successful, the reduction in the antral and gastric body gastritis score was significantly greater than in patients without eradication. In the OAM group, 39.1% of the patients (n = 90) reported one or more side effects, compared with 44.7% (n = 101) in the RAM group (P= 1.5449, NS).

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Eradication of H. pylori based on a second 13C-urea breath test was successful in 95% (95% confidence interval (CI) = 90-100%) of patients receiving omeprazole triple therapy and 53% (95% CI = 41-65%) of those receiving omeprazole dual therapy (P < 0.0001 between groups, all data available analysis). The all-patients-treated analysis gave eradication rates of 80 and 44% for omeprazole triple therapy and omeprazole dual therapy, respectively. Symptomatic relapse occurred in 16% (18/116) of the H. pylori-negative patients who entered the 12-month follow-up period, and there were significant reductions in the number of consultations, investigations and prescriptions relating to upper gastrointestinal symptoms compared with the 12 months prior to the eradication therapies (all P < 0.0001). The two treatment strategies were comparable in terms of the number of adverse events reported.

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Demodex mites are common commensals of the pilosebaceous unit in mammals. In humans, only two species (Demodex folliculorum and D. brevis) have been identified and have been implied to play a role in at least three facial conditions: pityriasis folliculorum, rosacea-like demodicidosis and so-called "demodicidosis gravis". However, there is no consensus to what degree the mites are causative of the skin pathology and how they might contribute to the disease. This review presents a demodicidosis case, discusses the clinical features of Demodex infestation in man and reviews its pathogenetic implications and the therapeutic options.

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Gestational age at the time of delivery or mean birth weight.

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Sporulation of Clostridium difficile during infection and persistence of spores within the gut could partly explain treatment failures and recurrence. However, the influence of antibiotics on sporulation is unclear. The objective of our study was to evaluate the impact of ciprofloxacin, metronidazole, piperacillin/tazobactam, tigecycline, and vancomycin on C. difficile sporulation in vitro.

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The purpose of the present study was to develop and optimize the emulgel system for MTZ (Metronidazole), a poorly water soluble drug. The pseudoternary phase diagrams were developed for various microemulsion formulations composed of Capmul 908 P, Acconon MC8-2, and propylene glycol. The emulgel was optimized using a three-factor, two-level factorial design, the independent variables selected were Capmul 908 P, and surfactant mixture (Acconon MC8-2 and gelling agent), and the dependent variables (responses) were a cumulative amount of drug permeated across the dialysis membrane in 24 h (Y 1) and spreadability (Y 2). Mathematical equations and response surface plots were used to relate the dependent and independent variables. The regression equations were generated for responses Y 1 and Y 2. The statistical validity of the polynomials was established, and optimized formulation factors were selected. Validation of the optimization study with 3 confirmatory runs indicated a high degree of prognostic ability of response surface methodology. Emulgel system of MTZ was developed and optimized using 2(3) factorial design and could provide an effective treatment against topical infections.

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A questionnaire survey focused on the management of acute diverticulitis was sent to all consultants, specialist registrars, and staff Thuoc Cefpodoxime Proxetil Dispersible Tablets 100mg -grade surgeons in general surgery in one United Kingdom region.

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A group of 30 patients with various grades of rosacea (I-IV) were investigated in a single-center, open-label study. They were treated with a topical gel with 4% Quassia amara extract Cefdinir Buy Online for 6 weeks. Response was evaluated by the flushing, erythema, telangiectasia, papules, and pustules scores. At the end of therapy, overall improvement, safety, and tolerability were assessed.

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One-week regimens containing furazolidone and clarithromycin in combination with TDB or a proton pump inhibitor Clindets Dosage fulfil the criteria for successful H. pylori therapy.

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It has been shown previously that tricyclic neuroleptics like clomipramine and chlorpromazine have lethal effects on Leishmania donovani and L. major, and other studies indicate that the phenothiazine inhibitors of trypanothione reductase are potential anti-trypanosomal and anti-leishmanial drugs. With this in mind and our original observation on the presence of trypanothione in Entamoeba histolytica HK9, we examined the possible inhibitory effects of various phenothiazine and tricyclic derivatives on this human parasite. We found that drugs like clomipramine (KD002), the most potent in vitro inhibitor of trypanothione reductase among 30 tricyclic compounds tested, at 25 microM after 24 h of culture under aerobic conditions, caused a substantial decrease in the number of E. histolytica HK9 trophozoites, from approx. 15 x 10 Soltrim Trimetoprima Sulfametoxazol Suspension Para Que Sirve (6) to 5.37 x 10(6) cells, and at 100 microM to 0.8 x 10(6) cells. A substantial inhibitory effect on cell proliferation could also be demonstrated with metronidazol (used clinically against amoebiasis). Under similar experimental conditions other tricyclic and phenothiazine derivatives (OFKs), designed originally to inhibit the trypanothione reductase of trypanosomatides, had an inhibitory effect of 16 to 95%. For comparison, similar results were obtained using clomipramine and a phenothiazine derivative (OFK006) with Trypanosoma cruzi and Crithidia luciliae, except that with the latter the inhibitory effect of clomipramine was less dramatic. Experiments comparing two E. histolytica strains showed that normal cell proliferation under anaerobiosis was higher in strain HK9 than in HM1, which is highly virulent, but that metronidazol and clomipramine were less effective against HM1. Two other drugs tested, diphenydramine (KD005) and a phenothiazine derivative (OFK008), also had significant but lower inhibitory effects on both strains. The inhibitory activity on cell proliferation and the lytic effects on this human parasite by the tricyclic compounds clomipramine, chlorpromazine and others, as well as by the phenothiazine derivatives, indicate that they can be considered potential anti-amoebic agents.

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Seventy-eight consecutive children with H pylori infection were randomized to receive either sequential treatment (omeprazole plus amoxicillin for 5 days, followed by omeprazole plus clarithromycin plus tinidazole for another 5 days) (n = 38; 15 boys [39.5%]; median age, 11.0 years [range, 3.3-16 years]) or triple therapy (omeprazole, amoxicillin, and metronidazole Pinamox Suspension Spc ) for 1 week (n = 37; 15 boys [40.5%]; median age, 9.9 years [range, 4.3-16 years]). H pylori infection was based on 2 out of 3 positive tests results: 13C-urea breath test, rapid urease test, and histologic analysis. Eradication was assessed by 13C-urea breath test 8 weeks after therapy.

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The Cedrox Bd 500 Mg aim of this systematic review was to compare the clinical effectiveness of systemic antibiotics administered in the active stage of periodontal treatment or after the healing phase.

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Biopsies from 135 dyspeptic patients were cultured on Brucella blood agar. Pure cultures of H. pylori isolates were used for antibiotic susceptibility tests. Disk diffusion method was recruited to assess the susceptibility of H. pylori isolates to different dilutions of the above mentioned antimicrobials. Results obtained from the two groups were compared and minimum inhibitory concentrations Cefuroxime Axetil Ear Infection determined.

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Bacterial vaginosis (BV) is common in lesbians, and treatment fails in up to 28%. Risks include sexual behaviours that Amodex Infection Urinaire transmit vaginal fluid. The authors measured efficacy of a behavioural intervention to reduce sexual transfer of vaginal fluid between female sex partners in reducing BV persistence.

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The study included 70 patients undergoing an IPAA. For these patients, an evaluation by PDAI was performed prospectively at 1-2 years after the ileostomy closure. When the symptoms relevant to bowel movement appeared, PDAI was evaluated and metronidazole or ciprofloxacin was administered. Pouchitis was diagnosed in patients with PDAI scores of 7 or higher. The patients whose PDAI score was less than 7 and who responded to antibiotic therapy were defined as treatment responders having disease not diagnosed by PDAI (TR-NDPDAI).

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Clinical study in a mixed ICU in a university hospital.

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A multi-residue analytical method has been developed and validated for determining a selection of 16 pharmaceuticals: the anti-epileptic carbamazepine, seven analgesic/anti-inflammatory drugs (mefenamic acid, indomethacine, ibuprofen, naproxen, diclofenac, ketorolac and acetaminophen), the analgesic opiate codeine, two antidepressants (fluoxetine and paroxetine), beta-blockers (atenolol and propranolol), antibiotic (trimethoprim, metronidazole, and erythromycin) and the anti-ulcer ranitidine in hospital effluent wastewaters. The method allows simultaneous extraction of the pharmaceuticals compounds by solid-phase extraction (SPE) using the Waters Oasis HLB at pH 7. The analytes were then identified and quantitatively determined by liquid chromatography-tandem mass spectrometry (LC-MS-MS) using multiple reaction monitoring (MRM). Recoveries of the pharmaceuticals were higher than 75%, with the exception of ranitidine (45%) and the overall variability of the method was below 9%. The instrumental detection limit (IDL) varied between 2 and 31 pg injected, the method detection limit (LOD) was between 7 and 47 ng/L in spiked hospital effluent. The precision of the method, calculated as relative standard deviation (RSD), ranged from 0.3 to 4.9%. A detail study off matrix effect is included in this work, regarding to signal suppression in these effluent wastewaters from a hospital complex samples. The developed analytical method was applied for preliminary data results in effluent wastewaters from a hospital.