• Investigative Magnetic Resonance Imaging
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• v.22 no.3
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• pp.200-203
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• 2018

Metronidazole is an antimicrobial agent widely used for the treatment of anaerobic infection or antibiotics-associated diarrhea. It is generally thought to be safe, but can induce reversible toxic encephalopathy in the case of excessive or cumulative over-dose. Metronidazole-induced encephalopathy generally demonstrates the characteristic features of typical lesion location and bilaterality on magnetic resonance imaging (MRI). We report a case of metronidazole-induced encephalopathy with the involvement of asymmetric white matter. To our knowledge, only a few cases have been reported with respect to white matter lesion characteristics on MRI with diffusion-weighted images.

• Korean Journal of Veterinary Research
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• v.54 no.1
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• pp.27-30
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• 2014

The jejunum is the longest part of the small intestine and its lumen is mainly involved in the absorption of the nutrients. The present study was conducted to evaluate the effects of metronidazole, ceftriaxoine sodium and their combination on the stenotic index of the end to end jujunal anastomotic site. To accomplish this, 20 healthy stray dogs were subjected to end to end jejunal ansastmosis. Dogs in Group A (control) underwent jejunal anstomosis with no antibiotic prophylaxis, while those in Group B received surgery and metronidazole alone at 50 mg/kg, those in Group C received ceftriaxone sodium intravenously at 30 mg/kg body weight prior to surgery and dogs in Group D were given metronidazole in combination with ceftriaxone sodium at 50 mg/kg and 30 mg/kg, respectively, 2 h before surgical intervention. No significant difference (p > 0.05) in the stenotic index was observed at 14 days after jejunal anastomosis. These findings indicate that prophylactic administration of metronidazole and ceftriaxone sodium alone or in combination had no significant effect on the stenotic index of the jejunum.

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.2
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• pp.20-37
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• 2010

Purpose: The objective of this study was to observe the antibacterial effects of Sasangjasaebang (SSJSB) aqueous extracts, traditionally used for treating various gynecological diseases including vaginitis in Korea and their individual components - Cnidi Fructus(CF), Zanthoxyli Fructus(ZF) and Alumen(AL) against Gardnerella vaginalis ATCC14018, and combination effects of SSJSB extracts and Metronidazole were also monitored in this study. Methods: Antibacterial activities against Gardnerella vaginalis ATCC14018 of SSJSB (CF : ZF : AL = 10 : 3 : 3) aqueous extracts and their individual components were detected using standard agar microdilution methods. In addition, the effects on the bacterial growth curve were also monitored at MIC and $MIC{\times}2$ levels. The combination effects of SSJSB aqueous extracts and Metronidazole were observed by Checkboard Microtiter Assay and effects on bacterial growth curve treated with SSJSB aqueous extracts MIC + Metronidazole MIC, 1/2MIC and 1/4MIC, respectively. In the present study, Gardnerella vaginalis ATCC14018 were incubated under $37^{\circ}C$, 10% CO2 and bacterial growth curves were calculated at 24, 48, 72, 96 and 120 hrs after incubations. Results: MIC of CF aqueous extracts, ZF aqueous extracts, AL powders and SSJSB aqueous extracts against Gardnerella vaginalis ATCC14018 were detected as $27.5\;{\pm}\;13.693$(12.5~50), $6.875\;{\pm}\;3.423$(3.125~12.5), $4.375\;{\pm}\;1.713$(3.125~6.25) and $2.188\;{\pm}\;0.856(1.563{\sim}3.125)mg/m{\ell}$, respectively. MIC of Metronidazole was detected as $7.6\;{\pm}\;5.367(2{\sim}16){\mu}g/m{\ell}$ at same conditions. In addition, Metronidazole, CF aqueous extracts, ZF aqueous extracts, AL powders, and SSJSB aqueous extracts showed marked dosage-dependent inhibition of bacterial growth, and more dramatical inhibitions were detected in Metronidazole 1/2 MIC + SSJSB aqueous extracts MIC treatment as compared with each of single Metronidazole MIC and SSJSB aqueous extracts MIC treatments, respectively. Especially, quite similar inhibitory effects on bacterial growth were detected in Metronidazole 1/4 MIC + SSJSB aqueous extracts MIC treatment as compared with single Metronidazole MIC treatment in the present study. FIC index were detected as $0.475\;{\pm}\;0.137$(0.375~0.625) at Checkboard Microtiter Assay. Conclusion: The results obtained in this study suggest that CF aqueous extracts, ZF aqueous extracts, AL powders, and SSJSB aqueous extracts showed antibacterial effects against Gardnerella vaginalis ATCC14018, and they also showed dosage-dependent inhibitory effects on the bacterial growth. More potent antibacterial effects were detected in SSJSB aqueous extract as compared with individual components, respectively. In addition, combination treatment of SSJSB aqueous extract and Metronidazole showed more potent inhibitory effects on the growth of Gardnerella vaginalis with FIC index $0.475\;{\pm}\;0.137$(0.375~0.625). According to these results, the combination of SSJSB aqueous extract and Metronidazole is synergistic, and it is expected that effective dosages of Metronidazole could be reduced to 1/4 levels in combination with SSJSB extracts. And it might be needed to make further studies to seek the herbs which have antibacterial effects on the Gardnerella vaginalis ATCC14018.

• Journal of Life Science
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• v.17 no.5 s.85
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• pp.723-727
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• 2007

Resistance to metronidazole in Helicobacter pylori results from inactivation of rdxA and frxA, the chromosomal genes for a nitroreductase that normally converts metronidazole from prodrug to bactericidal agent. Two types of metronidazole susceptible strains had been found distinguishable by their apparent levels of frxA expression. Most common in the populations we had studied were strains that required only rdxA inactivation to become resistant to moderate levels of metronidazole(type I strains). The second strain type required inactivation of both frxA and rdxA to become resistance to metronidazole(type II strains): this was linked to a relatively high level of frxA gene transcription in the type II strains. The fdxA gene regulated fdxA as well as rdxA gene. Thus, to study the function of fdxA as a regulatory gene we constructed a null mutant of fdxA in H. pylori genome and identified over-and under-expressed proteins by fdxA using two-dimensional(2-D) electrophoresis and MALDI-TOP-MS. There were four over-expressed proteins in fdxA mutant; nifU-like protein(HP0221), frxA(HP0642), nonheme ferritin(HP0653), and hypothetical protein(HP0902). Three under-expressed proteins were also identified in fdxA mutant, including 5'-methylthioadenosine/S-adenosylhomocysteine nucleosidase (HP0089), (3R)-hydroxymyristoyl ACP dehydratase(HP1376), and thioredoxin(HP1458).

• The Journal of the Korean Society for Microbiology
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• v.34 no.6
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• pp.543-554
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• 1999

The purpose of this study was to evaluate the existence of amoxicillin, clarithromycin, and metronidazole resistance Helicobacter pylori and to determine the in-vitro MIC of two and three kinds of antibiotic concominant administration in the isolates. The antimicrobial agents tested against 169 H. pylori included metronidazole, amoxicillin, ciprofloxacin, clarithromycin, omeprazole, josamycin, erythromycin, and tetracycline. MIC of each antimicrobial agents was determined by broth microdilution method. The 169 strains of H. pylori were isolated from biopsy specimens of patients with gastric cancer. $MIC_{50}$ of clarithromycin, amoxicillin, metronidazole, omeprazole, erythromycin, josamycin, tetracycline, and ciprofloxacin was 2.0, 1.0, 4.0, 8.0, 0.5, 0.5, and $0.5\;{\mu}g/ml$, respectively. $MIC_{90}$ of clarithromycin, amoxicillin, metronidazole, omeprazole, erythromycin, josamycin, tetracycline, and ciprofloxacin was 64.0, 64.0, 32.0, 16.0, 8.0, 2.0, and $1.0\;{\mu}g/ml$, respectively. H. pylori isolates were detected in the following resistaince rates: 34.3% to clarithromycin, 31.9% to metronidazole, 20.7% to amoxicillin, 12.4% to erythromycin, and 10.1% to josamycin. The prevalence of the antibiotic resistant strains of H. pylori were detected 18.1% for two kind of antibiotics and 9.6% for three kind of antibiotics, and 3.9% for four kind of antibiotics. The $MIC_{90}$ of clarithromycin-, metronidazole-, and amoxicillin-resistant H. pylori was decreased under the $1\;{\mu}g/ml$ by the two or three kind of antibiotic concomitant administration in-vitro. These results suggest that two or three antibiotics concomitant administration could be more effective for the treatment of clarithromycin-, amoxicillin-, metronidazole-, and josamycin-resistant H. pylori strains.

• Journal of Periodontal and Implant Science
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• v.28 no.1
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• pp.57-70
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• 1998

The purpose of this study was to evaluate the clinical and microbiological effects of metronidazole 25% dental gel that was applied to periodontal pockets who have moderate to advanced chronic adult periodontitis were selected for this study. The quadrants that had 2 or 3teeth with 5-8mm probing pocket depth were selected and divided into test side and control side according to the split-mouth design. The metronidazole 25% dental gel applied on test side and 0.12% chlorhexidine solution applicated on positive control side, normal saline irrigation into periodontal pocket was applicated to negative control side respectively. Above procedures followed scaling and root planing at baseline(0week). The subgingival sterile saline irrigation and chlorhexidine irrigation were done for about 30 seconds respectively. The metronidazole 25% dental gel was applied to periodontal pocket at 0,1 week in the test side. The clinical and microbiological analysis carried out at baseline(0week) and 4,8 weeks. The results of this study were as follows; 1. The sulcular bleeding index, probing pocket depth were significantly reduced in the test group. The relative proportions of spirochetes and motile rods were significantly reduced to negative control group and the proportion of cocci was correspondingly increased in the test group. 2. The sulcular bleeding index, probing pocket depth were significantly reduced in metronidazole group. and, there was a significant differences between 2 groups. Also, the relative proportions of spirochetes and motile rods were reduced in both group. And, there was a significant differences between 2 groups. In conclusion, application of metronidazole 25% dental gel as an adjunct to mechanical debridement of root surfaces may improved the clinical and microbiological status of periodontal disease sites.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.3
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• pp.103-106
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• 2018

Objectives: The goal of the study was to investigate the clinical effects of amoxicillin-clavulanic acid (500+125 mg) with metronidazole 400 mg administered three times daily (Group I) versus azithromycin 500 mg administered once daily and with metronidazole 400 mg three times daily (Group II) for the prevention of postoperative infection following mandibular third molar surgical removal. Materials and Methods: The study design was a single-center prospective study. Patients who reported to the Department of Oral and Maxillofacial Surgery between February 2015 and January 2017 for removal of mandibular third molar were screened, and 108 patients were chosen. One surgeon carried out all procedures. Patients were prescribed antibiotics until the two groups contained a similar number of cases. Results: Our data showed that Group II had fewer incidences of surgical site infection, but with no statistical significance. Conclusion: Although both treatments are used routinely after removal of the mandibular third molar, neither is significantly better than the other.

• Journal of Veterinary Clinics
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• v.22 no.3
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• pp.239-243
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• 2005

Current treatments for canine Giardia infections include albendazole, fenbendazole and metronidazole in the most cases. To compare efficacy of these antimicrobial drugs for treating naturally infected giardiasis in dogs, we used the zinc sulfate concentration technique(ZSCT) to figure out naturally infected with Giardia. In this study, feces were collected from 150 asymptomatic dogs at a kennel, 28 asymptomatic Giardia infected dogs were used by the allocated four group to receive albendazole(group A, 25 mg/kg, PO, bid, 7 days), fenbendazole(group F, 50 mg/kg, PO, sid, 7 days), metronidazole (group M, 50 mg/kg, PO, sid, 7 days), nontreated control(group NC) respectively. Fecal samples from each dog were examined for Giardia cysts within 3 days of the last treatment. Giardia cysts were not detected in the feces of any dog in group F. Cysts were detected in the feces 1 of 7 dogs in group A or in the feces 2 of 7 dogs in group M. In the group NC, cysts were detected in the feces of 7 of 7 dogs. Finally, there was significant difference for efficacy between antimicrobial drugs against Giardia in dogs. Fenbendazo1e is the most efficacy to have giardiacidal activity.

• YAKHAK HOEJI
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• v.52 no.3
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• pp.225-231
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• 2008

To clarify effects of the structural changes of Fur protein on the resistance to metronidazole (Mtz), the mutational analysis of structure and function of the protein in Helicobacter pylori (Hp) was undertaken. It was identified that some changes in Hp Fur protein resulted in increase of resistance to Mtz, and other changes resulted in decrease of resistance. Increase of Mtz resistance came from the enzyme's decreased ability of reducing prodrug Mtz to the form of bactericidal agent. Some sites that affects Mtz resistance (i) in Fur's N terminal extension, and (ii) in its central region, which links DNA binding and Fe-binding modules were identified. It was also found that the addition of FLAG tag to Fur's C terminus also significantly impairs Fur function.

• Journal of the Korean neurological association
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• v.36 no.4
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• pp.322-324
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• 2018

Oculogyric crisis is an acute dystonia involving ocular muscles characterized by sustained conjugate upward or lateral deviation of the eyes. Metronidazole is a commonly used antimicrobial agent in treatment of anaerobic infections. However, its long-term use can cause toxic encephalopathy particularly in patients with hepatic dysfunction. Here, we describe a case of oculogyric crisis as a presenting manifestation of metronidazole-induced encephalopathy.