Effect
Nitroimidazoles are antibacterial (bactericidal) and antiparasitic. They are reduced under anaerobic conditions to cytotoxic metabolites that covalently bind to and damage DNA. The damage may take the form of loss of helical structure, impaired matrix function, or strand breaks, leading to inhibition of DNA synthesis.
Indications
Spectrum: gram-positive and gram-negative anaerobic bacteria and some parasites. Infections caused by anaerobic bacteria:
- Bacteroides fragilis
- Clostridia
- Fusobacteria
- Campylobacter (metronidazole)
- Gardnerella vaginalis
Parasitic infections caused by protozoa:
- Amoebiasis (intestinalis and hepatica).
- Infections with trichomonads in the urogenital tract: trichomoniasis.
- Giardiasis
- African trypanosomiasis
Rosacea:
- Topical metronidazole (eg, Rosalox, Perilox): all manifestations of rosacea, especially the papulopustular form see topical metronidazole for rosacea.
Other indications:
- Metronidazole: pseudomembranous colitis, Helicobacter pylori.
- Ornidazole and tinidazole: prevention of postoperative infections caused by anaerobes, especially in colon, gastrointestinal tract and gynecology procedures.
Agents
For detailed information, please see:
- Metronidazole (Flagyl, generic).
- Metronidazole for the external treatment of rosacea.
- Ornidazole (Tiberal)
- Benznidazole (Rochagan, Radanil)
- Fexinidazole (Fexinidazole Winthrop).
- Secnidazole
- Tinidazole (Fasigyn) is out of trade in many countries.
