metronidazole oral / Generic mfg. - LARVOL DELTA

When the Gut Brews Its Own Poison: D-Lactic Acidosis from SIBO After Total Colectomy (ACG 2026) - "He was treated with bicarbonate and oral metronidazole with resolution of high ostomy output and full neurologic and metabolic recovery...Normal L-lactate does not exclude D-lactic acidosis, as standard assays are stereospecific. Clinicians should suspect D-lactic acidosis in any post-colectomy patient with unexplained HAGMA, normal L-lactate, and encephalopathy."

Acute Kidney Injury • CNS Disorders • Gastrointestinal Disorder • Metabolic Disorders • Nephrology • Renal Disease • Short Bowel Syndrome

Sepsis Secondary to Amoebic Liver Abscess in Pregnancy: A Delayed Presentation After Remote Travel (ACG 2026) - "The patient was initiated on piperacillin-tazobactam and comprehensive testing was orderd...The gold-standard of treatment for ALA is oral metronidazole for 7-10 days, followed by another 7 days of oral paromomycin to ensure intestinal eradication...This case highlights the importance of a broad differential for liver abscesses in an era of increasing global migration. Figure: Ill-defined hypodense mass with rim enhancement in the right hepatic lobe on Contrast enhanced CT of the Abdomen Figure: Hypoechoic lesion with low level internal echoes on hepatic ultrasound"

Cardiovascular • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Inflammation • Septic Shock

Intestinal Spirochetosis: A Rare Mimic of Inflammatory Bowel Disease (ACG 2026) - "The patient was prescribed a course of oral metronidazole; however, she was unable to be reached after colonoscopy...Figure: Figure 1: Organisms stain intensely with silver impregnation stain (Warthin-Starry stain). Figure: Figure 2: The Treponema pallidum immunohistochemical stain is similarly positive for spirochetosis."

Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease

Amebic Colitis Masquerading as Inflammatory Bowel Disease: A Diagnostic Challenge in the Returning Traveler (ACG 2026) - "He was then treated with 10 days course Flagyl...In patients with recurrent colitis, travel exposure, atypical endoscopic findings, or an inconsistent clinical course, repeated and expanded infectious evaluation should be pursued before establishing a diagnosis of IBD. Figure: Cecum from colonoscopy in 2020 showing erythema and ulcerations Figure: Most recent colonoscopy showing worsening inflammation with increased erythema and ulcers."

Colorectal Cancer • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease

Case Report of Diagnostic Challenge in Eosinophilic Colitis (EC) With Indeterminate Initial Colonoscopy Findings (ACG 2026) - "Brief trial of Flagyl, Sucralfate provided no relief...The patient was diagnosed with EC, and was discharged with prednisone taper with follow-up to discuss further management options...Treatment options include allergen elimination, systemic corticosteroids, and alternative agents for steroid-sparing approaches. We believe this case will aid clinicians in identifying and managing this rare condition."

Case report • Clinical • Anorexia • Colorectal Cancer • Eosinophilia • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Hematological Disorders • Immunology • Inflammation • Rare Diseases

Use of Intestinal Ultrasound to Monitor Segmental Colitis Associated With Diverticulosis (SCAD) (ACG 2026) - "He was treated with Ciprofloxacin and Flagyl for 14-days without response on a subsequent colonoscopy. Figure: Fig 1: Pre-treatment color doppler image demonstrating hyperemia in an area of segmental colitis with associated diverticulosis. Figure: Fig 2: Pre-treatment B-mode ultrasound image demonstrating increased bowel wall thickness in an area of segmental colitis with associated diverticulosis."

Colonic Polyps • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation

Photobiomodulation With Blue LED in Recurrent Bacterial Vaginosis (clinicaltrials.gov) - P=N/A | N=40 | Not yet recruiting | Sponsor: Patricia Lordelo

New trial • Vaginitis

Bilateral ascending dry gangrene following documented smear-positive malaria in a patient with multivalvular rheumatic heart disease and normal CT angiography findings: a case report. (PubMed, Int J Surg Case Rep) - "She was treated with intravenous furosemide, ceftriaxone, metronidazole, oral azithromycin, and subcutaneous enoxaparin, but because the gangrene was already advanced, she ultimately underwent bilateral below-knee amputations. This case highlights malaria-associated SPG as a rare but devastating cause of bilateral lower-limb gangrene. In malaria-endemic settings, new distal pain, discoloration, or gangrenous change after malaria should prompt urgent evaluation because delayed recognition may result in irreversible necrosis and major amputation."

Journal • Cardiovascular • Heart Failure • Hematological Disorders • Infectious Disease • Malaria • Musculoskeletal Pain • Pain • Vasculitis

Suspected Metronidazole-Induced Acute Pancreatitis in a Three-Year-Old Child Following Treatment for Entamoeba histolytica Gastroenteritis: A Case Report. (PubMed, Cureus) - "A previously healthy three-year-old boy (weight: 15 kg) developed AP six days after completing a 10-day course of oral metronidazole, 150 mg (10 mg/kg/dose) three times daily prescribed for amoebic gastroenteritis diagnosed by stool microscopy...Although a definitive causal relationship cannot be established, the temporal association with metronidazole exposure, together with the systematic exclusion of more common pediatric etiologies, supports the possibility of a drug-related adverse event. Clinicians should consider AP in children presenting with persistent vomiting and upper abdominal pain during or after metronidazole therapy while recognizing that causality cannot be confirmed from a single case report."

Journal • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Hepatology • Infectious Disease • Mood Disorders • Pain • Pancreatitis • Pediatrics

NAMAD: Non-antibiotic Management in Acute Uncomplicated Diverticulitis (clinicaltrials.gov) - P4 | N=0 | Withdrawn | Sponsor: Montefiore Medical Center | N=556 ➔ 0 | Not yet recruiting ➔ Withdrawn

Enrollment change • Trial withdrawal • Gastrointestinal Disorder

A Case Report of an Asymptomatic Cecum Ulceration Colonoscopically and Radiologically Mimicking Inflammatory Bowel Disease Caused by Amebic Colitis. (PubMed, Case Rep Gastroenterol) - "The case was provisionally diagnosed as inflammatory bowel disease and received oral metronidazole and probiotics...The absence of obvious symptoms in this patient further increased the diagnostic difficulty. We recommend that clinicians consider invasive amebiasis in their list of differential diagnosis even in asymptomatic patients presenting with colonic ulceration."

Journal • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Pain

Adjunctive probiotic therapy enhances metronidazole efficacy in bacterial vaginitis: a clinical trial on Iranian women. (PubMed, GMS Hyg Infect Control) - "The study compared the efficacy of a 7-day regimen of oral metronidazole (2×500 mg/d) and a vaginal probiotic (Lactobacillus plantarum 299v 1×109 cfu/day over 21 days) to the same regimen with a placebo instead the probiotic...With the combination therapy being well-tolerated and no serious adverse events reported. The study suggest, that vaginal probiotics may be a promising adjunctive therapy for BV, although further studies are needed to confirm these findings and determine the optimal probiotic strains and dosage, as well as to investigate the potential benefits of probiotics for other aspects of BV management Other factors such as dietary habits, hygiene practices, and lifestyle were not controlled in this study and should be considered in future research."

Journal • Gynecology • Vaginitis

Neglected Syphilis in Pregnancy Presenting as Condyloma Lata with Subsequent Congenital Syphilis: A Case Report. (PubMed, Int J Womens Health) - "Treatment consisted of intramuscular benzathine penicillin G (2.4 million units) and oral metronidazole (2 g)...This case highlights that delayed antenatal syphilis screening and late maternal treatment may allow progression to secondary syphilis with condyloma lata and increase the risk of congenital syphilis. Early screening and timely treatment are essential to prevent vertical transmission."

Journal • Human Immunodeficiency Virus • Infectious Disease • Nephrology • Vaginitis

MOTIF: Vaginal Microbiota Transplant (clinicaltrials.gov) - P1/2 | N=62 | Recruiting | Sponsor: Douglas Kwon | Trial completion date: Sep 2026 ➔ Jun 2027 | Trial primary completion date: Sep 2026 ➔ Jan 2027

Trial completion date • Trial primary completion date • Transplantation • Vaginitis

Clostridioides difficile osteomyelitis presenting as a Brodie's abscess of the tibia. (PubMed, BMJ Case Rep) - "Imaging showed a proximal tibial lytic lesion and aspiration of a superficial collection grew C. difficile Symptoms persisted despite 4 weeks of oral amoxicillin-clavulanate (875-125 mg every 12 hours) plus oral metronidazole (500 mg every 8 hours)...He underwent excisional debridement with dead-space management and local vancomycin, followed by prolonged pathogen-directed antimicrobials. Two deep intraoperative cultures again yielded rare C. difficile with negative aerobic and blood cultures. He improved without amputation and remained stable at 9-month follow-up."

Journal • Chronic Kidney Disease • Infectious Disease • Inflammation • Nephrology • Oncology • Pain • Renal Disease

Adjunct vaginal lactic acid with single-dose metronidazole for bacterial vaginosis: a randomized controlled trial. (PubMed, BMC Womens Health) - "Adjunct vaginal lactic acid added to single-dose oral metronidazole did not significantly improve early vaginal Lactobacillus recovery or reduce 6-month bacterial vaginosis recurrence. However, women receiving adjunct therapy experienced a significantly higher one-week clinical cure rate and faster malodor relief, with only mild and tolerable vaginal irritation. These findings suggest that adjunctive vaginal lactic acid provides a feasible short-term symptomatic treatment option in resource-limited Southeast Asian settings, although its role in improving long-term microbiological outcomes remains uncertain."

Journal • Gynecology • Obstetrics • Vaginitis

Oral metronidazole versus clindamycin to treat bacterial vaginosis in pregnancies at risk for preterm labor. (PubMed, Clin Microbiol Infect) - P=N/A | "In pregnant women at high risk for preterm labor, oral metronidazole and clindamycin for the treatment of BV/AVF demonstrated similar efficacy, adverse effect profiles, and preterm delivery rates."

Journal • Vaginitis

A case of giardiasis discovered during treatment for inflammatory breast cancer. (JBCS 2026) - "Treatment for FN was continued, and treatment for giardiasis (oral metronidazole) was initiated...Currently, bone marrow function has normalized, and docetaxel can be resumed, but at the patient's request, treatment is being continued with anti-HER2 therapy (Fesgo) only, and the progress is good. Giardiasis is not a disease that is frequently encountered, with a detection rate of less than 0.5% in urban areas of Japan today, but on a global scale, the number of infected people is estimated to reach several hundred million. When diarrhea is observed during drug treatment, there is a possibility that a rare disease causing diarrhea, such as giardiasis, is hidden, so it is important not to assume that it is due to drug use or simple enteritis, but to confirm with a stool culture."

Clinical • Breast Cancer • Febrile Neutropenia • Gastrointestinal Disorder • Hepatology • HER2 Breast Cancer • HER2 Positive Breast Cancer • Infectious Disease • Inflammatory Breast Cancer • Neutropenia • Oncology • Rare Diseases • Solid Tumor

The Use of Low Dose Metronidazole to Decrease Postoperative Pain After Endometriosis Surgery (clinicaltrials.gov) - P4 | N=78 | Terminated | Sponsor: University of Louisville | Active, not recruiting ➔ Terminated; Principal investigator did not have the necessary staffing resources to continue the study.

Trial termination • Endometriosis • Gynecology • Pain • Women's Health

REaCT-NSQIP: Comparing No Mechanical Bowel Preparation With Oral Antibiotics Alone in Patients Undergoing Elective Colon Surgery (clinicaltrials.gov) - P4 | N=630 | Active, not recruiting | Sponsor: Ottawa Hospital Research Institute | Trial completion date: Jul 2026 ➔ Oct 2026 | Trial primary completion date: May 2026 ➔ Aug 2026

Trial completion date • Trial primary completion date

Non-operative versus operative management of uncomplicated acute appendicitis: a randomized controlled study in Sierra Leone. (PubMed, BMC Surg) - "NOM for uncomplicated acute appendicitis achieved a 60% success rate with a low recurrence rate (3.3%). It is associated with lower costs, reduced risk of catastrophic health expenditure, shorter hospital stays, faster return to normal activities, and improved QoL compared to operative management."

Journal • Gastroenterology • Gastrointestinal Disorder

NAMAD: Non-antibiotic Management in Acute Uncomplicated Diverticulitis (clinicaltrials.gov) - P4 | N=556 | Not yet recruiting | Sponsor: Montefiore Medical Center

New P4 trial • Gastrointestinal Disorder

Impacts of storage conditions on the dissolution performance of commercial metronidazole tablets available in Saudi Arabia. (PubMed, Saudi Pharm J) - "Furthermore, in vitro dissolution of the product C stored at 40oC ± 2 oC/75 % RH ± 5 % for 3 months with further protection against high humidity revealed an improvement in the dissolution parameters due to the similar protective effects exerted by the two packaging forms. Furthermore, the study shows that storage conditions such as humidity and temperature affect in vitro dissolution of MTZ marketed tablets which may have an impact on efficiency and patient safety."

Journal

Molecular characterization, phylogenetic analysis, and successful therapeutic management of Babesia gibsoni infection in a 1.5-year-old female spitz from Tripura. (PubMed, J Parasit Dis) - "The therapy included a combination of oral metronidazole, doxycycline, and clindamycin which resulted in a favourable response. The dog regained appetite and vigor by the 10th day post-treatment. To the best of the authors' knowledge, this is one of the few documented reports from Tripura that provides a comprehensive analysis of genetic characterization, phylogenetics, hemato-biochemical findings, and serum oxidant-antioxidant status of the infection, while also contributing to the understanding of its evolutionary relationships within the Babesia genus."

Journal • Eosinophilia • Hematological Disorders • Hypoglycemia • Infectious Disease • Neutropenia • Thrombocytopenia

The LISA (Lactoferrin InStead of Antibiotics/Antifungals) Feasibility Study (clinicaltrials.gov) - P=N/A | N=114 | Recruiting | Sponsor: Guy's and St Thomas' NHS Foundation Trust | Not yet recruiting ➔ Recruiting

Enrollment open • Vaginitis