Metronidazole-induced Metallic Taste: A Systematic Review and Meta-Analysis

Karrar, Hani Raka; Nouh, Mahmoud Ismail; Alhendi, Rehab Salah Aldin; Nouh, Yousef Ismail; Nooh, Mawadah Ismaeel; Almansour, Ramlah Abdulfattah; Alayafi, Yahya Hasan; Alharthy, Baidaa Talal; Albarrak, Sarah Khalid; Alshame, Hanin Ali

doi:10.9734/jpri/2021/v33i58a34120

Cited by 2 publications

(2 citation statements)

References 32 publications

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“…A metallic taste because of tinidazole in sequential therapy can also contribute to reduced compliance. 29 Adverse events were reported in < 9% patients in the levofloxacin group which was significantly less compared to that in the sequential therapy group (38.8%). This difference in adverse events is largely because of the higher rate of bad/metallic taste in the sequential group which could be attributed to tinidazole (27.5%).…”

Section: Discussionmentioning

confidence: 81%

Outcome of 14-Day Sequential and Levofloxacin-Based Triple Regimen as the First-Line Therapy in Patients with Helicobacter pylori Infection: A Prospective Comparative Study from Southern Central Nepal

Ranjan,

Neupane,

Maharjan

et al. 2024

Journal of Gastrointestinal Infections

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Background Helicobacter pylori eradication rates of the commonly used regimens vary among countries and even among different regions of the same country. We aimed to compare the eradication rate and safety of sequential therapy with levofloxacin-based triple therapy. Methods A comparative single-center study was conducted between October 2022 and November 2023 after obtaining ethical approval. Patients in group A received 14 days of levofloxacin-based triple therapy and those in group B received 14 days of sequential therapy. The eradication of H. pylori was assessed 4 weeks after the completion of the assigned regimens. The data regarding adverse events were also recorded. Results Among 150 patients (group A: 70, group B: 80) with mean age of 41.7 ± 15.0 years, 67 (44.6%) were male. The eradication was achieved in 65 (92.9%) in group A and 63 (78.8%) in group B, respectively (p = 0.01). All the patients in group A and 76 (95%) patients in group B had good compliance with medication. Adverse events were noticed in 7 (10%) in group A compared to 31 (38.7%) in group B (p < 0.001). The most common adverse events in group A and group B were drug-related diarrhea (3 [4.3%] vs. 11 [13.7%]), gastrointestinal intolerance (2 [2.8%] vs. 6 [7.5%]), and bad/metallic taste (1 [1.4%] vs. 22 [27.5%]). No serious adverse events were noted in both groups. Conclusion Sequential therapy is significantly less effective and has more nonserious adverse events compared to levofloxacin-based triple therapy in eradication of H. pylori.

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Section: Discussionmentioning

confidence: 81%

Outcome of 14-Day Sequential and Levofloxacin-Based Triple Regimen as the First-Line Therapy in Patients with Helicobacter pylori Infection: A Prospective Comparative Study from Southern Central Nepal

Ranjan,

Neupane,

Maharjan

et al. 2024

Journal of Gastrointestinal Infections

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“…The adherence rate for the higher dose was 93.9%. Taste distortion most likely occurred with the high dose of metronidazole [ 42 ].…”

Section: Evidence For the Treatment Of H Pylori In...mentioning

confidence: 99%

Treatment of Helicobacter pylori Infection in Patients with Penicillin Allergy

Liu

Nahata

2023

Antibiotics

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Helicobacter pylori is among the prevalent causes of infections worldwide, and its resistance rate to antibiotics has been rising over time. Amoxicillin is the cornerstone for the treatment regimen. However, the prevalence of penicillin allergy ranges from 4% to 15%. In patients with true allergy, Vonoprazan-Clarithromycin-Metronidazole and bismuth quadruple therapy have demonstrated excellent eradication and high adherence rates. Vonoprazan-based therapy is administered less frequently and may be better tolerated than bismuth quadruple therapy. Therefore, vonoprazan-based therapy may be considered as a first-line therapy if accessible. Bismuth quadruple therapy can be used as the initial therapy when vonoprazan is unavailable. Levofloxacin or sitafloxacin-based regimens achieve a moderately high eradication rate. However, these are associated with potentially serious adverse effects and should only be used when other effective and safer regimens are unavailable. Cephalosporins such as cefuroxime have been used as an alternative to amoxicillin. Microbial susceptibility studies can guide the selection of appropriate antibiotics. PPI-Clarithromycin-Metronidazole fails to achieve a high eradication rate and should be used as a second-line therapy. PPI-Clarithromycin-Rifabutin should not be used because of low eradication rate and frequent adverse reactions. The choice of the most effective antibiotic regimen can enhance clinical outcomes in patients with H. pylori infection and penicillin allergy.

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Metronidazole-induced Metallic Taste: A Systematic Review and Meta-Analysis

Cited by 2 publications

References 32 publications

Outcome of 14-Day Sequential and Levofloxacin-Based Triple Regimen as the First-Line Therapy in Patients with Helicobacter pylori Infection: A Prospective Comparative Study from Southern Central Nepal

Outcome of 14-Day Sequential and Levofloxacin-Based Triple Regimen as the First-Line Therapy in Patients with Helicobacter pylori Infection: A Prospective Comparative Study from Southern Central Nepal

Treatment of Helicobacter pylori Infection in Patients with Penicillin Allergy

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