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Is metronidazole end of the line for Clostridium difficile infection?Metronidazole (Flagyl) has been one of the most commonly used antibiotics for Clostridium difficile infection for years, but there has been a shift in recommendations lately. Is this the end of the line with metronidazole for Clostridium difficile infection? An infectious diseases pharmacist provides insights here.
What should I know about Flagyl (metronidazole) before taking it?Metronidazole is not used in early pregnancy because of potential adverse effects on the fetus. Metronidazole is excreted in breast milk. Females who are nursing, because of potential adverse effects on the newborn, should not use metronidazole. What else should I know about Flagyl (metronidazole)?
What are the contraindications for flibanserin and metronidazole?
Coadministration of flibanserin with moderate or strong CYP3A4 inhibitors is contraindicated. Severe hypotension or syncope can occur. metronidazole increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increases lomitapide levels several folds.
Is it safe to give metronidazole to children with CDI?It is important to note that metronidazole is still recommended for the treatment of CDI in children according to the 2017 IDSA/SHEA guidelines. Keep in mind that prolonged or repeated courses of metronidazole increase the risk of neurotoxicity.
When to switch from metronidazole to oral vancomycin for C diff?Thus, given the increasingly virulent nature of C. difficileinfections, particularly in the nosocomial environment, an argument can be made to presume treatment failure after 3 days of metronidazole if there is no decrease in diarrhea or abdominal discomfort, and a switch to oral vancomycin should be considered.
Are macrolides and penicillins risk factors for C diff?
Macrolides, sulfonamides/trimethoprim, and penicillins are associated with a moderate risk of C difficile infection with odds ratios between about 1.8 and 3.3. 3-5 Within this group, penicillins are generally associated with a slightly higher risk (odds ratio about 50% higher) compared to macrolides and sulfonamides/trimethoprim.
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