The Experts below are selected from a list of 303 Experts worldwide ranked by ideXlab platform
Stuart Noble - One of the best experts on this subject based on the ideXlab platform.
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Topical Metronidazole
American Journal of Clinical Dermatology, 2000Co-Authors: Karen J. Mcclellan, Stuart NobleAbstract:Topical application of the antibacterial agent Metronidazole is effective in the treatment of moderate to severe rosacea, although its mechanism of action has yet to be clearly established. Metronidazole preparations (0.75 and 1% cream, 0.75% gel and 0.75% lotion) were significantly more effective than placebo in patients with moderate to severe rosacea when administered to the affected area once or twice daily for 7 to 12 weeks. The mean number of papules and pustules decreased by between 48 and 65.1% during the treatment period. Reductions were fairly consistent regardless of formulation, strength or application frequency and were significant compared with placebo (p < 0.05). In 1 study, most of the overall effects of Metronidazole were observed within the first 3 weeks. Although data are limited, topical Metronidazole appears to improve inflammatory lesions and erythema as effectively as oral tetracyclines. Like tetracyclines, however, Metronidazole has no effect on telangiectasia. Metronidazole 0.75% gel seems to be effective in maintaining remission of rosacea symptoms in patients successfully treated with both oral tetracycline and topical Metronidazole. In the only study, 77% of patients treated with Metronidazole gel compared with 58% of placebo recipients (p < 0.05) remained in remission 6 months after the tetracycline was stopped. The effects of topical Metronidazole preparations on rosacea symptoms are palliative, not curative, but preliminary data suggest that relapse rates after cessation of therapy are no worse than those after cessation of oral oxytetracycline. Topical Metronidazole formulations are generally well tolerated locally, with stinging, dryness, burning and itching reported in ≤2% of patients. Because minimal concentrations of Metronidazole are absorbed after topical administration, systemic adverse events and drug interactions seen with oral or intravenous Metronidazole are unlikely. Conclusions Topical Metronidazole formulations are significantly more effective than placebo when used in the initial treatment of patients with moderate to severe rosacea. Furthermore, limited evidence suggests that the use of topical Metronidazole alone may be as effective as oral tetracyclines against the disorder’s inflammatory component. Therefore, for those patients with a preference for topical rather than oral therapy, the use of a topical Metronidazole formulation must be a consideration.
Peter James Mcdonald - One of the best experts on this subject based on the ideXlab platform.
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Comparison of cefotaxime plus Metronidazole versus cefoxitin for prevention of wound infection after abdominal surgery
World Journal of Surgery, 1995Co-Authors: James Toouli, Judith Brookman, Peter James McdonaldAbstract:Con el propósito de comparar la eficacia de un régimen de cefotaxime más metronidazol con cefoxitina en la prevención de las infecciones de herida, se realizó un estudio prospectivo y randomizado que cubrió a 1010 pacientes sometidos a cirugía abdominal. También se valoró la eficacia de una dosis única de los antibióticos versus tres dosis en el curso de 24 horas. El estudio demostró que el régimen de dosis única de antibiótico fue tan efectivo como el régimen de dosis múltiples en la profilaxis de la infección de herida en cirugía abdominal y, además, señaló que la combinación de cefotaxime y metronidazol es comparable a la de la cefoxitina y es de mayor costo/eficacia. In a randomized prospective stratified trial consisting of 1010 patients undergoing abdominal surgery involving the viscera, the efficacy of cefotaxime plus Metronidazole was compared to cefoxitin for preventing wound infection. The efficacy of a single dose of antibiotics versus three doses over 24 hours was also evaluated. This study demonstrated that a single-dose antibiotic regimen was as effective as a multiple-dose regimen in the prophylaxis of wound infections following abdominal surgery. In addition it demonstrated that the cefotaxime plus Metronidazole regimen is comparable to that of cefoxitin and is more cost-effective. It is concluded that a single dose of cefotaxime plus Metronidazole provides effective prophylaxis against postoperative wound infections following abdominal surgery. Dans cette étude randomisée, et stratifiée, on a comparé l'efficacité du céfotaxime combiné au métronidazole et du céfotaxime seul, ainsi que leur efficacité en une seule prise par rapport à trois prises, dans la prévention des infections pariétales chez 1010 patients ayant une intervention abdominale concernant les viscères. Une seule prise est aussi efficace que trois. Il n'y avait pas de différence d'efficacité en ce qui concerne les deux traitements d'antibiotiques. Le céfotaxime combiné au métronidazole a un meilleur rapport coût efficacité. Nous recommandons la combinaison céfotaxime et métronidazole dans la prévention des infections pariétales après chirurgie abdominale.
W. Evan Secor - One of the best experts on this subject based on the ideXlab platform.
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In Vitro Metronidazole and Tinidazole Activities against Metronidazole- Resistant Strains of Trichomonas vaginalis
Antimicrobial agents and chemotherapy, 2003Co-Authors: Andrea L. Crowell, Kolby Sanders-lewis, W. Evan SecorAbstract:The in vitro activities of tinidazole and Metronidazole against Trichomonas vaginalis isolates clinically resistant to Metronidazole were compared. Minimal lethal concentrations (MLCs) of tinidazole were significantly lower than MLCs of Metronidazole. Increased Metronidazole resistance correlated with increased tinidazole resistance. These data support a role for tinidazole in the treatment of trichomoniasis.
Karen J. Mcclellan - One of the best experts on this subject based on the ideXlab platform.
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Topical Metronidazole
American Journal of Clinical Dermatology, 2000Co-Authors: Karen J. Mcclellan, Stuart NobleAbstract:Topical application of the antibacterial agent Metronidazole is effective in the treatment of moderate to severe rosacea, although its mechanism of action has yet to be clearly established. Metronidazole preparations (0.75 and 1% cream, 0.75% gel and 0.75% lotion) were significantly more effective than placebo in patients with moderate to severe rosacea when administered to the affected area once or twice daily for 7 to 12 weeks. The mean number of papules and pustules decreased by between 48 and 65.1% during the treatment period. Reductions were fairly consistent regardless of formulation, strength or application frequency and were significant compared with placebo (p < 0.05). In 1 study, most of the overall effects of Metronidazole were observed within the first 3 weeks. Although data are limited, topical Metronidazole appears to improve inflammatory lesions and erythema as effectively as oral tetracyclines. Like tetracyclines, however, Metronidazole has no effect on telangiectasia. Metronidazole 0.75% gel seems to be effective in maintaining remission of rosacea symptoms in patients successfully treated with both oral tetracycline and topical Metronidazole. In the only study, 77% of patients treated with Metronidazole gel compared with 58% of placebo recipients (p < 0.05) remained in remission 6 months after the tetracycline was stopped. The effects of topical Metronidazole preparations on rosacea symptoms are palliative, not curative, but preliminary data suggest that relapse rates after cessation of therapy are no worse than those after cessation of oral oxytetracycline. Topical Metronidazole formulations are generally well tolerated locally, with stinging, dryness, burning and itching reported in ≤2% of patients. Because minimal concentrations of Metronidazole are absorbed after topical administration, systemic adverse events and drug interactions seen with oral or intravenous Metronidazole are unlikely. Conclusions Topical Metronidazole formulations are significantly more effective than placebo when used in the initial treatment of patients with moderate to severe rosacea. Furthermore, limited evidence suggests that the use of topical Metronidazole alone may be as effective as oral tetracyclines against the disorder’s inflammatory component. Therefore, for those patients with a preference for topical rather than oral therapy, the use of a topical Metronidazole formulation must be a consideration.
Kenneth C Lamp - One of the best experts on this subject based on the ideXlab platform.
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Metronidazole
Drugs, 1997Co-Authors: Collin D Freeman, Neil E. Klutman, Kenneth C LampAbstract:The nitroimidazole antibiotic Metronidazole has a limited spectrum of activity that encompasses various protozoans and most Gram-negative and Gram-positive anaerobic bacteria. Metronidazole has activity against protozoans like Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis , for which the drug was first approved as an effective treatment. Anaerobic bacteria which are typically sensitive are primarily Gram-negative anaerobes belonging to the Bacteroides and Fusobacterium spp. Gram-positive anaerobes such as peptostreptococci and Clostridia spp. are likely to test sensitive to Metronidazole, but resistant isolates are probably encountered with greater frequency than with the Gram-negative anaerobes. Gardnerella vaginalis is a pleomorphic Gram-variable bacterial bacillus that is also susceptible to Metronidazole. Helicobacter pylori has been strongly associated with gastritis and duodenal ulcers. Classic regimens for eradicating this pathogen have included Metronidazole, usually with acid suppression medication plus bismuth and amoxicillin. The activity of Metronidazole against anaerobic bowel flora has been used for prophylaxis and treatment of patients with Crohn’s disease who might develop an infectious complication. Treatment of Clostridium difficile-induced pseudomembraneous colitis has usually been with oral Metronidazole or vancomycin, but the lower cost and similar efficacy of Metronidazole, coupled with the increased concern about imprudent use of vancomycin leading to increased resistance in enterococci, have made Metronidazole the preferred agent here. Metronidazole has played an important role in anaerobic-related infections. Advantages to using Metronidazole are the percentage of sensitive Gram-negative anaerobes, its availability as oral and intravenous dosage forms, its rapid bacterial killing, its good tissue penetration, its considerably lower chance of inducing C. difficile colitis, and expense. Metronidazole has notable effectiveness in treating anaerobic brain abscesses. Metronidazole is a cost-effective agent due to its low acquisition cost, its pharmacokinetics and pharmacodynamics, an acceptable adverse effect profile, and its undiminished antimicrobial activity. While its role as part of a therapeutic regimen for treating mixed aerobic/anaerobic infections has been reduced by newer, more expensive combination therapies, these new combinations have not been shown to have any therapeutic advantage over Metronidazole. Although the use of Metronidazole on a global scale has been curtailed by newer agents for various infections, Metronidazole still has a role for these and other therapeutic uses. Many clinicians still consider Metronidazole to be the ‘gold standard’ antibiotic against which all other antibiotics with anaerobic activity should be compared.
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Metronidazole. A therapeutic review and update.
Drugs, 1997Co-Authors: Collin D Freeman, Neil E. Klutman, Kenneth C LampAbstract:The nitroimidazole antibiotic Metronidazole has a limited spectrum of activity that encompasses various protozoans and most Gram-negative and Gram-positive anaerobic bacteria. Metronidazole has activity against protozoans like Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis, for which the drug was first approved as an effective treatment. Anaerobic bacteria which are typically sensitive are primarily Gram-negative anaerobes belonging to the Bacteroides and Fusobacterium spp. Gram-positive anaerobes such as peptostreptococci and Clostridia spp. are likely to test sensitive to Metronidazole, but resistant isolates are probably encountered with greater frequency than with the Gram-negative anaerobes. Gardnerella vaginalis is a pleomorphic Gram-variable bacterial bacillus that is also susceptible to Metronidazole. Helicobacter pylori has been strongly associated with gastritis and duodenal ulcers. Classic regimens for eradicating this pathogen have included Metronidazole, usually with acid suppression medication plus bismuth and amoxicillin. The activity of Metronidazole against anaerobic bowel flora has been used for prophylaxis and treatment of patients with Crohn's disease who might develop an infectious complication. Treatment of Clostridium difficile-induced pseudomembraneous colitis has usually been with oral Metronidazole or vancomycin, but the lower cost and similar efficacy of Metronidazole, coupled with the increased concern about imprudent use of vancomycin leading to increased resistance in enterococci, have made Metronidazole the preferred agent here. Metronidazole has played an important role in anaerobic-related infections. Advantages to using Metronidazole are the percentage of sensitive Gram-negative anaerobes, its availability as oral and intravenous dosage forms, its rapid bacterial killing, its good tissue penetration, its considerably lower chance of inducing C. difficile colitis, and expense. Metronidazole has notable effectiveness in treating anaerobic brain abscesses. Metronidazole is a cost-effective agent due to its low acquisition cost, its pharmacokinetics and pharmacodynamics, an acceptable adverse effect profile, and its undiminished antimicrobial activity. While its role as part of a therapeutic regimen for treating mixed aerobic/anaerobic infections has been reduced by newer, more expensive combination therapies, these new combinations have not been shown to have any therapeutic advantage over Metronidazole. Although the use of Metronidazole on a global scale has been curtailed by newer agents for various infections, Metronidazole still has a role for these and other therapeutic uses. Many clinicians still consider Metronidazole to be the 'gold standard' antibiotic against which all other antibiotics with anaerobic activity should be compared.
