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Pharmacology: Pharmacodynamics: Metronidazole is active against anaerobic bacteria. The drug is readily taken up by bacterial cells and reduced by intracellular electron transport proteins. This generates free radicals which interacting with cell components and leads to bacterial cell death.
Pharmacokinetics: Metronidazole is well absorbed and distributed into cerebrospinal fluid, saliva and breast milk in concentrations equal to concurrent plasma concentrations of the drug.
The drug is metabolized in the liver and excreted mostly in urine and some in feces as unchanged drug and metabolites.
Metronidazole is active in vitro against many susceptible microorganisms as following; Anaerobic gram-negative bacilli: Bacteroides species including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus and Fusobacterium species.
Anaerobic gram-positive bacilli: Clostridium species and some strains of Eubacterium species.
Anaerobic gram-positive cocci: Peptococcus niger and Peptostreptococcus species.
Moreover the drug also has activity against Gardnerella vaginalis, Entamoeba histolytica, Trichomonas vaginalis, Giardia lamblia and Balantidium coli.
Injection: It is also distributed to hepatic abscess in concentration similar to concentration in plasma. Metronidazole is less than 20% bound to plasma proteins.
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