Metronidazole and amebiasis

Everett, E. Dale

doi:10.1007/bf01073018

Cited by 11 publications

(3 citation statements)

References 18 publications

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“…The low success of metronidazole is in contrast to various other studies reporting 90–100 per cent efficacy of the drug 1 , 4 , 23 . Failure with metronidazole therapy in ALA has been widely reported 23 , 24 . Possible explanations suggested for the failure include inadequate intestinal absorption, resistance of the organism to the drug and persistent unrecognised intestinal infection 2 .…”

Section: Management Of Amoebic Liver Abscess Medicalmentioning

confidence: 98%

Amoebic liver abscess in a North Indian hospital — current trends

Sharma

Sarin

1987

Int J Clinical Practice

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Section: Management Of Amoebic Liver Abscess Medicalmentioning

confidence: 98%

Amoebic liver abscess in a North Indian hospital — current trends

Sharma

Sarin

1987

Int J Clinical Practice

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“…This compound has subsequently proven to be effective in amebiasis and in several other parasitic infections (3,4,6). Recently metronidazole was found to be active in vitro against anaerobic microorganisms, and experience is being accumulated on the use of this agent in anaerobic infections (1,5,10).…”

mentioning

confidence: 99%

Metronidazole Bioassay

Speck

Stein

Rosenkranz

1976

Antimicrob Agents Chemother

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Urine from patients receiving metronidazole [1-(2-hydroxyethyl)-2-methyl-5-nitromidazole]' orally or per vagina were subjected to paper chromatographic fractionation and examined for anticlostridial activity. Unmodified metronidazole and several metabolites were detected. These findings indicate that the clostridial bioassay may be limited in its applicability to the study of the pharmacodynamics of metronidazole as it does not differentiate between the parent substance and some of its metabolites. Moreover, some of the latter, although they possess antibacterial activity, may not have antiprotozoan activity.Metronidazole was initially described in 1959 as an agent with specific trichomonicidal activity (2). This compound has subsequently proven to be effective in amebiasis and in several other parasitic infections (3,4,6). Recently metronidazole was found to be active in vitro against anaerobic microorganisms, and experience is being accumulated on the use of this agent in anaerobic infections (1,5,10). The metabolism of metronidazole and the basis of its activity are still poorly understood. Recently a bioassay utilizing Clostridium was described as being useful for determining the concentration of metronidazole in body fluids (7). The purpose of this report is to present findings which suggest that this bioassay may be restricted in its usefulness.MATERIALS AND METHODS Urine specimens. The urine specimens were obtained from patients who had received metronidazole (Flagyl, Amersham/Searle, Arlington Heights, Ill.) for a period in excess of 24 h. Firstvoided morning specimens were obtained, sterile filtered, and stored in the cold. Ten specimens were used in this study, eight from patients with vaginitis receiving 250 mg orally three times a day, one from a vaginitis patient treated per vagina 250 mg three times a day, and one from a patient with an amebic abscess receiving 750 mg orally three times a day.Bioassay. For bioassay only recent clinical isolates of C. perfringens were used. There were no differences among the clostridial strains with respect to susceptibility to metronidazole or its metabolites. Blood agar plates were inoculated with approximately 107 microorganisms in 0.1 ml. When the surface of the agar had dried, filter papers impregnated with urine were deposited on the surface of the plates, and these were incubated anaerobically (Gas-Pak system, BBL, Cockeysville, Md.) at 37 C for 18 h, whereupon zones of growth inhibition were measured.Paper chromatography. Quantities (100 gil) of urine were applied across 15 cm of Whatman 3MM paper, and descending chromatography was carried out with 1-butanol saturated with water (86:14). Development was allowed to proceed for a minimum of 45 cm. The chromatogram was then dried and inspected under an ultraviolet lamp, and areas (2 by 2 cm) were excised. These were numbered and placed on the surface of blood agar plates inoculated with C. perfringens. The plates were handled as described above, and zones of growth inhibition were measured. RESULTSAnticlostrid...

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“…Metronidazole was first introduced into clinical medicine in 1959 for the treatment of Trichomonas vaginalis infections (2), and it has been subsequently used for invasive amebiasis and giardiasis (4,22). Recent studies have documented its in vitro bactericidal activity against anaerobic bacteria (14).…”

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Antimicrobial activity of metronidazole in anaerobic bacteria

Tally¹,

Goldin²,

Sullivan³

et al. 1978

Antimicrob Agents Chemother

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The antimicrobial activity of metronidazole was investigated in anaerobic bacteria by use of time-viability studies. This antimicrobial agent has a rapid onset of bactericidal activity under proper reducing conditions. The bactericidal rates were not affected by inoculum size or nutritional requirements, nor by inhibition of growth and protein synthesis by chloramphenicol. Using supernatant fractions of actively growing cultures of susceptible organisms, we observed a disappearance of metronidazole and a loss of biological activity, but there was no significant change in preparations from resistant bacteria. The decrease in drug concentration with susceptible cells occurred during the time that its bactericidal action was being exerted. Extracts from susceptible organisms rapidly reduced the concentration of metronidazole, confirming previous observations which suggest that the drug acts as a terminal electron acceptor. Radioisotope experiments with ['4C]metronidazole revealed that the compound was taken up by both resistant and susceptible bacteria, although there was a difference in rate and extent of accumulation. These studies demonstrate that mentronidazole's antimicrobial activity against anaerobic bacteria is bactericidal and independent of growth rate, and that it involves the uptake and metabolism of the compound.

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Metronidazole and amebiasis

Cited by 11 publications

References 18 publications

Amoebic liver abscess in a North Indian hospital — current trends

Amoebic liver abscess in a North Indian hospital — current trends

Metronidazole Bioassay

Antimicrobial activity of metronidazole in anaerobic bacteria

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