Low
Excellent (90 to 100%)
IV/PO$
Suspected or confirmed anaerobic infections including intra-abdominal, biliary, central nervous system, Clostridium difficile, Giardia, and pelvic infections.
Also used in Crohns disease, bacterial vaginosis, and hepatic encephalopathy
CBC with differential at baseline and after prolonged or repeated courses of therapy
With prolonged therapy (>6wks) or if symptoms develop assess for peripheral/optic neuropathy
GI symptoms common - especially nausea/vomiting and metallic taste
Peripheral/optic neuropathy with extended therapy
Disulfiram-like reaction (severe vomiting)
Rare neurotoxicity including aseptic meningitis and encephalopathy
Disulfiram reaction with alcohol or alcohol-containing medications/products
May enhance the QT prolongation of drugs which are known to prolong the QT interval
May increase the serum concentration of vitamin K antagonists (warfarin)
Bacterial, protozoal and ameobic DNA is fragmented by reactive nitroso-imidazole radicals
Antimicrobial class: Nitroimidazole
Average serum half life:
Neonates <7 days: (prolonged with lower GA) 24.8-75.3 hours.
Neonates ≥7 days: ~22.5 hours
Children and adolescents: 6-10 hours.
Adults: 8 hours
Route of Elimination:
Urine (unchanged drug and metabolites: 50%; ~20% of total as unchanged drug)
Feces (20%)
