ABSTRACT
METRONIDAZOLE Pharmacology Metronidazole [1-(2-hydroxyethyl)-2-methyl-5-nitroimidazole], a nitroimidazole antimicrobial, was introduced in 1960 and rapidly became the treatment of choice for Trichomonas vaginalis (1). Metronidazole has been used clinically for over 40 years and was initially regarded as an antiprotozoal agent, used for such infections as trichomoniasis, amebiasis, and giardiasis. Several years later, in the 1970s, the antibacterial activity of metronidazole versus obligate anaerobes was realized (2-5). Since that time, metronidazole has been used extensively for a multitude of anaerobic infections, such as those involving Clostridium difficile and Bacteroides spp. As metronidazole has been in use for over four decades, a superfluity of references concerning basic knowledge about metronidazole, including the mechanism of action, spectrum of activity, pharmacokinetics, adverse drug effects, clinical uses, and resistance exist, but pharmacodynamic data are lacking.
