Metronidazole is a narrow spectrum antibiotic active specifically against anaerobes.With improved culture techniques there has been an increased awareness of the pathogenic role of anaerobes such as bacteroides either alone or in conjunction with other organisms in the production of soft tissue infections.It is active against bacteroides,Clostridium difficile and some protozoa such as trichomonas and Giardia lamblia.It has proved highly effective in the management of most oral surgical infections in addition to acute ulcerative gingivitis.
Metronidazole is well absorbed when taken by mouth and can be given either 400 mg 12 hourly or 200 mg 8 hourly.Metronidazole intravenous infusion 500 mg 12 hourly is also very helpful.The drug penetrates abscesses well and crosses the blood-brain barrier.
Adverse reactions:
The side effects include an unpleasant metallic taste,nausea and gastro-intestinal upsets.It also causes rashes occasionally.Prolonged use may cause a reversible neuropathy.Some patients experience an antabuse effect with alcohol.