metronidazole oral / Generic mfg. - LARVOL DELTA

Revisiting the Disulfiram-Like Reaction Between Alcohol and Oral Metronidazole. (PubMed, Sex Transm Dis) - "While all four case reports and one older clinical trial reported a potential link between some oral 5-nitroimidazoles and DLR, 3 clinical trials, one cross-sectional chart review, and 2 experimental animal studies did not. Thus, the available evidence does not strongly support a clinically significant interaction between alcohol and oral MTZ, calling into question the need for strict alcohol abstinence during treatment."

Journal • Cardiovascular

Topical versus oral metronidazole for post-haemorrhoidectomy pain: A systematic review and meta-analysis of randomized controlled trials. (PubMed, Colorectal Dis) - "Topical and oral metronidazole showed similar short-term analgesic efficacy after haemorrhoidectomy."

Clinical • Journal • Retrospective data • Review • Pain

Study of Metronidazole Delayed-Release Capsules in Comparison With Immediate-Release Tablets (Flagyl) for Safety and Pharmacokinetics (clinicaltrials.gov) - P1 | N=18 | Completed | Sponsor: Gateway Pharmaceutical LLC

New P1 trial • Infectious Disease

Title of the Protocol: Combined Use of Vaginal Clindamycin Cream and Oral Metronidazole Versus Oral Metronidazole (clinicaltrials.gov) - P=N/A | N=100 | Completed | Sponsor: Ain Shams Maternity Hospital

New trial • Vaginitis

Metronidazole as Preoperative Therapy in CRC / FusoMetro-001 (clinicaltrials.gov) - P2 | N=40 | Recruiting | Sponsor: Oncology Institute of Southern Switzerland | Trial completion date: Dec 2024 ➔ Dec 2026 | Trial primary completion date: Dec 2024 ➔ Dec 2026

Trial completion date • Trial primary completion date • Colorectal Cancer • Oncology • Solid Tumor

Vaginitis: Diagnosis and Treatment. (PubMed, Am Fam Physician) - "Bacterial vaginosis is treated with oral or intravaginal metronidazole or intravaginal clindamycin...Trichomoniasis is treated with oral metronidazole or tinidazole. When treating trichomoniasis, testing for reinfection, as well as other sexually transmitted infections, is recommended. Treatments for noninfectious vaginitis include vaginal lubricants and moisturizers, topical hormones, and topical steroids, depending on the cause."

Journal • Review • Candidiasis • Dermatology • Gynecology • Infectious Disease • Inflammation • Pruritus • Vaginitis

REaCT-NSQIP: Comparing No Mechanical Bowel Preparation With Oral Antibiotics Alone in Patients Undergoing Elective Colon Surgery (clinicaltrials.gov) - P4 | N=630 | Recruiting | Sponsor: Ottawa Hospital Research Institute | Trial completion date: Dec 2026 ➔ Jul 2026 | Trial primary completion date: Sep 2025 ➔ May 2026

Trial completion date • Trial primary completion date

Male Partner Treatment and the Potential Sexual Transmission of Bacterial Vaginosis: Considerations for Patient Counseling and Clinical Application in the United States. (PubMed, Am J Obstet Gynecol) - "However, for the first time, an open-label, randomized controlled trial in Australia showed a decrease in BV recurrences in women whose male partners were treated with a combination of oral metronidazole and topical clindamycin cream over 12 weeks. This has resulted in increasing questions from patients regarding both MPT and the sexual transmissibility of BV. Here, we review evidence regarding the sexual transmission of BV, discuss complexities with potential implementation of MPT, and provide a framework from which to counsel patients."

Journal • Gynecology • Vaginitis

UNPACKING THE TEMPORAL RELATIONSHIP: G. VAGINALIS CLADES AND INCIDENT HIGH-RISK HPV INFECTION (IPVC 2025) - "When stratified by treatment, Clade 3 demonstrated a statistically significant interaction between HrHPV incidence and women receiving oral metronidazole (interaction p = 0.015)... This analysis suggests a potential treatment-dependent relationship between Clade 3 and HrHPV incidence. Treatment of BV appears to reduce HrHPV incidence in women with G.vag Clade 3. Further research is needed to clarify the clinical significance between G.vag clades and acquisition and/or clearance of HPV and to inform targeted STI prevention strategies."

Human Papillomavirus Infection • Infectious Disease • Vaginitis

A prospective, multicenter, randomized, double-blind, controlled phase III clinical study on the efficacy and safety of XLF055 combined with metronidazole in the prevention of recurrence of bacterial vaginosis (BV) (ChiCTR) - P3 | N=440 | Not yet recruiting | Sponsor: Peking University First Hospital; Peking University First Hospital

New P3 trial • Vaginitis

An Unexpected Infection: Diagnosing a Liver Abscess in a Young, Healthy Adult (ACG 2025) - "Patient was started started on Zosyn and underwent IR-guided drainage with cultures positive for E. coli. Antibiotics were deescalated to Flagyl and TMP/SMX...While this patient's colonoscopy was grossly normal, he was taking omeprazole outpatient...Figure B: Abdominal CT scan showing hepatic abscess. Abdominal MRI scan of hepatic abscess"

Clinical • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Inflammatory Bowel Disease • Pneumonia • ALK

Streptococcus constellatus Pyogenic Liver Abscess Resembling a Neoplastic Lesion: A Case Review (ACG 2025) - "Antibiotic therapy was narrowed to Rocephin and Flagyl. B. Axial MRCP portrayed a well-defined, segment 4, 14.4 x 9.8 x 15.9 cm T2 hyperintense liver lesion, with restricted diffusion, suggestive of malignancy."

Clinical • Review • Addiction (Opioid and Alcohol) • Cardiovascular • Diabetes • Fatigue • Gastrointestinal Cancer • Gastrointestinal Disorder • Hepatology • Infectious Disease • Metabolic Disorders • Pancreatitis

Unmasking a Hidden Parasite: Colonic Necrosis and Liver Abscess From Entamoeba histolytica (ACG 2025) - "Intravenous Unasyn and Flagyl were initiated, and a CT-guided drain was placed into the peri-colonic abscess...Figure B: RBC's ingested within the E. histolytica involving necrosis.Figure C: Zoomed out histology slide of the necrosis. Figure D: Gangrenous transmural necrosis with E. histolytica"

Cardiovascular • Developmental Disorders • Gastrointestinal Disorder • Hepatology • Hypertension • Infectious Disease • Septic Shock

When Suspicion Outpaces Confirmation: A Case of Suspected Invasive Entamoeba Histolytica (ACG 2025) - "He was started on flagyl and ceftriaxone, and a PICC line was placed for prolonged antibiotic treatment. histolytica antigen is often negative in extraintestinal disease despite colonic involvement, as fewer trophozoites are shed into the colon as the infection progresses to the liver, lowering antigen sensitivity. Even in low-prevalence areas like the U.S., a broad differential is crucial in patients with intermittent fevers and liver lesions.Figure: Patchy areas of ulceration seen in the cecumFigure: Liver mass seen on CT of the abdomen and pelvis"

Clinical • Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Hepatology • Hypertension • Immunology • Infectious Disease

Epiglottitis of an Unusual Etiology (ACG 2025) - "The patient was started empirically on IV Acyclovir, Fluconazole, Ceftriaxone, and Flagyl...Antibiotics were discontinued and he was discharged home on Valtrex...It has also been estimated that roughly 70% of patients affected with Herpes Zoster laryngitis are concurrently immunocompromised [2]. There have been reported findings of biopsy proven VZV epiglottitis in the order of single digits making this an exceedingly rare diagnostic finding especially in an immunocompetent host.Figure: Esophageal Herpetic Plaques"

Gastrointestinal Disorder • Herpes Zoster • Infectious Disease • Influenza • Otorhinolaryngology • Respiratory Diseases • Varicella Zoster

Hematemesis versus Hemoptysis: Identifying Key Differences to Guide Management in GI Bleeding (ACG 2025) - "She was initially treated with Ceftriaxone, Flagyl, and Vancomycin for possible sepsis and subsequently transitioned to Zosyn. A CTA of the Abdomen was helpful to determine whether there was an acute bleed in the abdomen. An endoscopy from GI allowed for a diagnosis of a perforated duodenal ulcer and later, clipping of the ulcer."

Bronchiectasis • Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Hypertension • Infectious Disease • Peptic Ulcer • Pulmonary Disease • Respiratory Diseases • Septic Shock • Thrombosis

Not Just Bacteria: A Case of Candida Glabrata Hepatic Abscess Post-Cholecystectomy and Stenting (ACG 2025) - "This case highlights that a fungal liver abscess can occur following cholecystectomy, even in patients with a normal immune system.Case Description/ Patient is a 53-year-old man who underwent open cholecystectomy 6 weeks ago due to necrosis of gallbladder and was discharged with ciprofloxacin and flagyl...Cultures grew Candida Glabrata and Streptococcus Intermedius and were treated with IV Ertapenem and Micafungin for a total of 6 weeks...Our patient grew C. glabrata with likely risk factors including recent surgery, prolonged hospital stay and antibiotic use. when bacterial cultures from a pyogenic abscess are sterile, it is advisable to consider the possibility of a fungal infection among immunocompetent patients, as appropriate antifungal treatment can lead to favorable outcomes.Figure: Figure 1Figure: Figure 2"

Clinical • Diabetes • Gastroenterology • Gastrointestinal Disorder • Hepatology • Infectious Disease • Metabolic Disorders

Gastric Delay, Bacterial Display: Sarcina Ventriculi in Gastroparesis (ACG 2025) - "Based on clinical presentation, the patient was treated with oral metronidazole 500 mg for 10 days.At the three-month follow-up, the patient reported complete resolution of symptoms...Reported antibiotic regimens include metronidazole, ciprofloxacin, amoxicillin-clavulanate, penicillin, or tetracyclines, often combined with proton pump inhibitors to reduce gastric acidity. Further studies are needed to clarify the pathogenic mechanisms and to establish when antimicrobial treatment is warranted. Until then its presence in gastroparesis cases should not be dismissed.Figure: Figure 1: Sarcina ventriculi histological examination"

Constipation • Diabetes • Dyspepsia • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Infectious Disease • Inflammation • Metabolic Disorders • Respiratory Diseases

Rare Presentation of Small Bowel Necrosis in the Setting of Fulminant Clostridioides difficile Infection After GLP-1 Usage (ACG 2025) - "He was initiated on oral vancomycin and IV Flagyl. Semaglutide and other glucagon-like peptide (GLP-1) medications have known reports of viral gastroenteritis in up to 4% of patients that use subcutaneous administration. This gastroenteritis may have led to alterations of the patient's microbiome, allowing for the bacteria to grow and expand into fulminant infection, causing his extensive complications."

Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Hypotension • Infectious Disease • Thrombosis

Beyond the Gut: Pyoderma Gangrenosum in a Late-Onset Presentation with Enterobacter Cloacae Infection and Crohn's Colitis (ACG 2025) - "Treatment with vancomycin and doxycycline was initiated...The patient was managed with a 2-week course of IV cefepime, IV Flagyl, and prednisone 40 mg daily, improving symptoms of both IBD and PG. Pyoderma gangrenosum (PG) is believed to result from immune dysregulation...Ustekinumab demonstrated effectiveness in managing PG.Figure: Pyoderma gangrenosum of the right leg- Deep ulcer with a raised, violaceous border. Erythema in the surrounding skin.Figure: Colonoscopy- Erythema and inflammation with punched-out ulcers."

Alzheimer's Disease • Breast Cancer • CNS Disorders • Crohn's disease • Dementia • Dermatology • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammatory Bowel Disease • Pyoderma Gangrenosum • Solid Tumor • Ulcerative Colitis

A randomized, open, positive drug-parallel-controlled, multicenter clinical study of lactobacillus vaginalis capsules for the treatment of bacterial vaginosis and vulvovaginal pseudomyxomatosis (ChiCTR) - P4 | N=210 | Completed | Sponsor: Obstetrics and Gynecology Hospital Affiliated to Fudan University; Obstetrics and Gynecology Hospital Affiliated to Fudan University

New P4 trial • Candidiasis • Vaginitis

UNCHARTED TERRITORY: FIRST REPORTED PELVIC ABSCESS CAUSED BY EGGERTHIA CATENAFORMIS IN AN IMMUNOCOMPROMISED PATIENT (CHEST 2025) - "The patient was started on oral Vancomycin Clostridium difficile and empirical Ertapenem for pelvic abscess...His antibiotics were streamlined to Meropenem oral Metronidazole...There is not currently an accepted treatment regimen; however, previous cases have noted sensitivity to penicillin, amoxicillin, piperacillin/tazobactam, clindamycin, metronidazole, meropenem, and vancomycin... Eggerthia catenaformis is a rare emerging pathogenic bacterium. It should be considered in the differential, particularly with patients with poor dental hygiene. To our knowledge, our patient is the first reported case of pelvic abscess caused by Eggerthia catenaformis."

Clinical • Cardiovascular • Crohn's disease • Dental Disorders • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Lumbar Back Pain • Movement Disorders • Musculoskeletal Pain • Restless Legs Syndrome • Rheumatology • Sleep Disorder

An amebic liver abscess in a female child with successful recovery in a non-endemic area: a case report. (PubMed, Front Pediatr) - "Following the diagnosis, the patient was treated with 10 days of oral metronidazole. A follow-up CT scan conducted 4 months later showed complete resolution of the liver abscess and normalization of liver function. While amebiasis is rare in pediatric populations, it should be considered in the differential diagnosis of liver abscesses, even in non-endemic regions."

Journal • Hepatology • Pain • Pediatrics

PRIMARY EMPYEMA IN THE SETTING OF CLOSTRIDIUM DIFFICILE INFECTION (CHEST 2025) - "Tube thoracostomy was performed and lytic therapy with alteplase and recombinant deoxyribonuclease was initiated...Most cases were found to be polymicrobial and standard broad-spectrum antibiotics as well as intravenous vancomycin or oral metronidazole were documented with variable success with most patients requiring some degree of surgical intervention [4]... When C. Difficile is isolated in the pleural space, pre-disposing conditions should be investigated. Multi-disciplinary intervention is usually required for successful treatment with antibiotics and surgery."

Acute Kidney Injury • Anorexia • Cardiovascular • Fatigue • Gastroenterology • Gastrointestinal Disorder • Infectious Disease • Melanoma • Nephrology • Pulmonary Embolism • Renal Disease • Respiratory Diseases • Solid Tumor • Thrombocytosis • CRP

SILENT PERFORATION: LIFE-THREATENING PNEUMO-MEDIASTINUM FROM NASOGASTRIC TUBE PLACEMENT IN AN ELDERLY PATIENT (CHEST 2025) - " Elderly patients are at high risk for complications during nasogastric tube (NGT) insertion due to factors like decreased pharyngeal reflexes and altered levels of consciousness [1]• Caution is essential when performing NGT insertion in elderly patients, with the use of multiple confirmation methods to ensure accurate placement.• Reported causes of cervical emphysema and pneumo-mediastinum include dental surgery, mastoid fractures, diastatic cecum rupture, and acute perforated diverticulitis, often treated with prophylactic antibiotics. • This case underscores the potential dangers of NG tube insertion, particularly in elderly patients, whose anatomical or functional vulnerabilities may heighten the risk of complications."

Clinical • Cardiovascular • Coronary Artery Disease • Diabetes • Endocrine Disorders • Gastrointestinal Disorder • Gout • Hypertension • Infectious Disease • Inflammatory Arthritis • Metabolic Disorders • Musculoskeletal Diseases • Nephrology • Orthopedics • Pulmonary Disease • Respiratory Diseases • Rheumatology • Type 2 Diabetes Mellitus