Ortem (metronidazole topical) / SLA Pharma - LARVOL DELTA

Metronidazole Ointment in Non-healing Pilonidal Sinus Wounds (clinicaltrials.gov) - P2; N=80; Not yet recruiting; Sponsor: S.L.A. Pharma AG; Trial completion date: May 2021 ➔ May 2022; Trial primary completion date: May 2021 ➔ Feb 2022

Clinical • Trial completion date • Trial primary completion date

[VIRTUAL] Understanding the Process Leading to Fecal Microbiota Transplantation in C. difficile (ACG 2020) - "Of these, nearly everyone was prescribed vancomycin, with trials of metronidazole and fidaxomicin as well. Referral source was recorded in 46% of patients. Of these, referrals were 63% from PCP, 20% from GI, 3% from ID, 3% from Geriatrics, 2% from Hospitalists, and 9% from another source. It transitioned primarily from GI to PCP over time."

Transplantation

[VIRTUAL] A Case of Hypopigmented Mycosis Fungioides (ASDP 2020) - "Topical metronidazole, Selsun blue, and oral terbinafine treatments failed to improve her condition...The patient was diagnosed with HMF and started on Clobetasol cream. Due to the lack of specific clinical features, as in this case, HMF is difficult to distinguish from many conditions presenting with hypopigmented macules or plaques, such as vitiligo, tinea corporis, and tinea versicolor. Histopathologic examination and ancillary studies are essential to clinch the diagnosis."

Clinical • Cutaneous T-cell Lymphoma • Dermatology • Mycosis Fungoides • Oncology • Pruritus • Vitiligo • CD8 • KIT

Treatment of pediatric periorificial dermatitis with topical calcineurin inhibitor and topical/oral metronidazole. (PubMed, J Dermatol) - "Herein, we evaluated the clinical efficacy of topical calcineurin inhibitors and topical/oral metronidazole in 24 Korean patients with pediatric periorificial dermatitis. The majority of the patients showed a complete response to treatment."

Clinical • Journal • Dermatitis • Dermatology • Immunology • Pediatrics

[VIRTUAL] Topical Therapy Pearls (FCPANP 2020) - "These vehicles, allowing for modulation of different solvents have allowed combinations of classic drugs such as betamethasone and calcipotriene, into one stable formulation. These new vehicles have laid the ground work for advances in rosacea therapy, including a new formulation of metronidazole that provides additional moisturization as well as a topical minocycline 1.5% foam. New vehicles have also improved classic acne therapy, such as the innovations with tazarotene 0.045% topical lotion with improved humectant and moisturization ability that maintains efficacy and reduces irritation and trifarotene for facial and truncal acne. Dr. Kircik ended his talk with the important take away message: vehicles matter."

Acne Vulgaris • Dermatology • Rosacea

Treating male partners of women with bacterial vaginosis (StepUp): a protocol for a randomised controlled trial to assess the clinical effectiveness of male partner treatment for reducing the risk of BV recurrence. (PubMed, BMC Infect Dis) - "Current treatments directed solely to women result in unacceptably high rates of BV recurrence. If proven to be effective the findings from this trial will directly inform the development of new treatment strategies to impact on BV recurrence."

Clinical • Journal • Obstetrics • Vaginitis

Topical analgesia following excisional haemorrhoidectomy: a systematic review and meta-analysis of randomised controlled trials. (PubMed, Int J Colorectal Dis) - "Topical diltiazem, metronidazole and sucralfate appear to significantly reduce pain at various timepoints following excisional haemorrhoidectomy. GTN had mixed evidence. Several single trials identified other promising topical analgesics."

Journal • Retrospective data • Review • Pain

Development of an Emulgel for the Treatment of Rosacea Using Quality by Design Approach. (PubMed, Drug Dev Ind Pharm) - "A metronidazole and niacinamide emulgel, also providing cosmetic assistance, was developed using QbD. The emulgel releases metronidazole faster than the creams, but more gradually than the commercially available gel, providing a realistic time frame of drug delivery in accordance with the expected time of residence of the adhesive emulgel over the affected facial area."

Journal • Dermatology • Rosacea

Application of a dermatopharmacokinetic (DPK) method for bioequivalence assessment of topical metronidazole creams. (PubMed, J Pharm Pharm Sci) - "The data obtained provides compelling evidence that the developed TS method has the potential to be a cost-effective surrogate alternative for lengthy and expensive clinical trials. Consequently, its application can facilitate faster development of generic products which would, in turn, lower the economic burden of healthcare."

Journal • PK/PD data • Dermatology • Rosacea

Topical Versus Oral Metronidazole Following Excisional Haemorrhoidectomy (clinicaltrials.gov) - P4; N=120; Completed; Sponsor: University of Auckland, New Zealand; Recruiting ➔ Completed; Trial completion date: Dec 2020 ➔ Feb 2020; Trial primary completion date: Jun 2020 ➔ Feb 2020

Clinical • Trial completion • Trial completion date • Trial primary completion date • Gastroenterology • Gastrointestinal Disorder • Pain

[VIRTUAL] A Rare Culprit in a Case of Budd-Chiari Syndrome (ACG 2020) - "Treatment was initiated with metronidazole and enoxaparin, which was bridged to warfarin. These proteins are known to induce a hypercoagulable state by depressing fibrinolysis, stimulating platelets to release PF4, and encouraging endothelial cellular exposure of tissue factor. Eosinophils have also been demonstrated to express additional tissue factor, which can activate the coagulation pathway via factor VII and X. This case demonstrates the importance of having parasitic infections on the differential as a cause of BCS with eosinophilia."

Clinical • Cardiovascular • CNS Disorders • Eosinophilia • Hematological Disorders • Hepatology • Hypertension • Pain • Portal Hypertension • Thrombosis

[VIRTUAL] Topical Analgesia Following Excisional Haemorrhoidectomy: A Systematic Review and Meta-Analysis of Randomised Controlled Trials (ACS-CLINCON 2020) - "Topical diltiazem, metronidazole and sucralfate appear to significantly reduce pain at various timepoints following excisional haemorrhoidectomy. GTN had mixed evidence. Several single trials identified other promising topical analgesics."

Retrospective data • Review • Pain

A Rapid Tool to Optimize Process Variables for Continuous Manufacturing of Metronidazole Ointment Using Melt Extrusion Technique. (PubMed, AAPS PharmSciTech) - "The metronidazole ointment prepared by twin screw processor was compared with commercially available metronidazole gel for in vitro release testing and ex vivo permeation. The flux, ex vivo bioavailability, and T of polyethylene glycol-based metronidazole ointment was found to be similar to that of marketed metronidazole gel."

Journal

[VIRTUAL] Topical versus Oral Metronidazole Following Excisional Haemorrhoidectomy: A Prospective, Double-Blind Randomised Controlled Trial (ACS-CLINCON 2020) - "Post-operative metronidazole as oral or topical routes are both suitable forms of analgesia following EH."

Clinical • Pain

The effect of Quercus (Oak Gal) vaginal cream versus metronidazole vaginal gel on bacterial vaginosis: A double‑blind randomized controlled trial. (PubMed, Complement Ther Med) - "Oak Gall could be recommended for women in reproductive age who are uncomfortable with the potential side effects of synthetic drugs."

Clinical • Journal • Gynecology • Pruritus • Vaginitis

Pharmacokinetics of Metronidazole Dermal Products (clinicaltrials.gov) - P1; N=12; Recruiting; Sponsor: University of Maryland, Baltimore; Trial completion date: Sep 2020 ➔ Mar 2021; Trial primary completion date: Sep 2020 ➔ Mar 2021

Trial completion date • Trial primary completion date

Topical Analgesia Post-Haemorrhoidectomy (clinicaltrials.gov) - P2/3; N=192; Recruiting; Sponsor: University of Auckland, New Zealand; Not yet recruiting ➔ Recruiting; Trial completion date: Jun 2022 ➔ Sep 2022; Trial primary completion date: Nov 2021 ➔ Aug 2022

Clinical • Enrollment open • Trial completion date • Trial primary completion date • Gastrointestinal Disorder • Pain

Interventions for rosacea based on the phenotype approach: An updated systematic review including GRADE assessments. (PubMed, Br J Dermatol) - "For reducing temporarily persistent erythema: there was high certainty evidence for topical brimonidine and moderate certainty for topical oxymetazoline; for erythema and mainly telangiectasia: low to moderate certainty evidence for laser and intense pulsed light therapy."

Journal • Review • Dermatology • Dermatopathology

Acute primary abdominal compartment syndrome due to Clostridium difficile induced toxic megacolon: a case report and review of the literature. (PubMed, Anaesthesiol Intensive Ther) - "Monitoring of intra-abdominal pressure allows early detection of abdominal compartment syndrome and is warranted in patients with C. difficile infection and/or toxic megacolon. Early decompression can lead to improved outcomes in patients with severe shock and organ failure."

Clinical • Journal • Acute Myelogenous Leukemia • Critical care • Gastrointestinal Disorder • Hematological Malignancies • Hypertension • Leukemia • Mood Disorders • Oncology • Septic Shock

A Case of Topical Metronidazole-Induced Encephalopathy. (PubMed, JAMA Neurol) - No abstract available

Clinical • Journal • CNS Disorders

20S proteasome as a drug target in Trichomonas vaginalis. (PubMed, Antimicrob Agents Chemother) - "A screen of proteasome inhibitors derived from a marine natural product, carmaphycin, revealed one derivative, carmaphycin-17, with greater activity against T. vaginalis than the reference drug metronidazole, the ability to overcome metronidazole resistance, and reduced human cytotoxicity compared to that of the anticancer proteasome inhibitors. In a murine model of vaginal trichomonad infection, proteasome inhibitors eliminated or significantly reduced parasite burden upon topical treatment without any apparent adverse effects. Together, these findings validate the proteasome of T. vaginalis as a therapeutic target for development of a novel class of trichomonacidal agents."

Journal • Oncology

Comparison of mean pain score using topical and oral metronidazole in post milligan morgan hemorrhoidectomy patient; A randomized controlled trial. (PubMed, Pak J Med Sci) - "Association of pain with respect to ages was insignificant (p=0.202) whereas between genders inside the groups showed significant difference (p=0.028). These results showed that topical metronidazole significantly reduces pain in post hemorrhoidectomy patients as compared to oral metronidazole overall and even when data stratified among age, gender and type of hemorrhoids."

Clinical • Journal • Gastrointestinal Disorder • Pain

[VIRTUAL] Refractory cutaneous-limited facial Rosai Dorfman disease (AAD-VMX 2020) - "She failed to respond to topical or systemic corticosteroids, topical calcineurin inhibitors, topical metronidazole, topical or oral dapsone, or minocycline. Serial intralesional steroid injections led to temporary improvement in the appearance of her papules, but progression continued. She started 15 mg oral methotrexate weekly and preliminary results are promising.⁴ Gold standard treatments have not been established in RDD, and the cumulative cure rate for all reported treatments is approximately 29%.³ Excision remains the most effective intervention, though challenging to implement in cosmetically sensitive areas.³ This case demonstrates a rare cutaneous variant of RDD and highlights the various treatment modalities used for this chronic, often refractory disease."

Langerhans Cell Histiocytosis • Oncology • Pain

Clinical effectiveness of novel rosacea therapies. (PubMed, Curr Opin Pharmacol) - "Topical ivermectin improves lesion count, inflammation, and maintenance of remission of rosacea compared to topical metronidazole. Procedural therapies including pulsed dye laser, radiofrequency, and dual frequency ultrasound are promising as both monotherapies or in combination. Although there are several effective treatment modalities for rosacea management, treatments options should be tailored for the specific clinical scenario."

Clinical • Journal • Review • Dermatology • Dermatopathology • Immunology • Rosacea

Metronidazole versus lactic acid for treating bacterial vaginosis (VITA): protocol for a randomised controlled trial to assess the clinical and cost effectiveness of topical lactic acid gel for treating second and subsequent episodes of bacterial vaginosis. (PubMed, Trials) - "Results from this trial will help inform UK treatment guidelines for BV and may provide an alternative effective treatment for recurrent episodes of this condition which avoids repeated exposure to antibiotics."

Clinical • HEOR • Journal