Intravenous metronidazole in the treatment and prophylaxis of anaerobic infection

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Abstract
Ninety patients were treated with intravenous metronidazole for possible anaerobic sepsis. In 42 patients anaerobic infection was confirmed and a complete cure was achieved in 76% of the courses of treatment given. Fifty-nine patients received metronidazole prophylactically prior to surgery. None of these patients developed significant anaerobic sepsis. Intravenous metronidazole was well tolerated in all 149 patients and local thrombophlebitis did not occur. One patient on high dosage of > 50 mg/kg developed a reversible sensory neuropathy. Two patients developed neutropenia while receiving metronidazole with cotrimoxazole. It is possible that this combination may cause neutropenia more readily than either drug alone. Nevertheless intravenous metronidazole can be recommended as safe and effective therapy for patients with suspected anaerobic sepsis. It is of particular value when the rapid achievement of bactericidal concentrations of the drug is required and in patients unable to take oral therapy or retain suppositories.

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