Microbiological properties of tinidazole: spectrum, activity and ecological considerations

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Abstract
Tinidazole, a 5-nitroimidazole, has activity against both anaerobic bacteria and protozoa. It is bactericidal at low concentrations and its antibacterial spectrum covers almost all anaerobic bacteria and some capnophilic micro-organisms. In-vitro susceptibility studies have shown that the minimum inhibitory concentration for over 90% of anaerobic bacteria is 2 mg/l. Tinidazole is rapidly bactericidal against Bacteroides fragilis and the activity is not affected by inoculum size or growth rate. Occasional strains of anaerobic Gram-positive cocci, and some Gram-positive nonsporulating rods are resistant to tinidazole. Propionibacteria and Actinomyces are almost uniformly resistant. The emergence of resistance in anaerobic bacteria during tinidazole treatment is rare. Enterobacteria are highly resistant to tinidazole; however, these bacteria may show increased sensitivity when examined under reduced conditions. Enhanced activity against enterobacteria has been noted both in vitro and in vivo when these organisms are tested in the presence of anaerobic bacteria. The effect of tinidazole on the normal human microflora of the mouth, throat and colon seems to be dependent on the doses used. When low doses are given, there are no changes in the normal flora while high doses cause a decrease in the number of anaerobic bacteria. After tinidazole treatment, however, the microflora is normal again within two weeks.

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