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Treatment and Prevention of Amebiasis
Published in Roberto R. Kretschmer, Amebiasis: Infection and Disease by Entamoeba histolytica, 2020
Administration — Metronidazole is usually administered orally at a dose of 2 g/day, in b.i.d. or t.i.d. fashion for a period of 5 to 10 days. The dose for children is 35 to 50 mg/kg/day also in three or four divided doses. Ornidazole and other derivatives are prescribed at the same dose.34 Powell35 used metronidazole at a dose of 2.4 g/day for 2 days to treat amebic dysentery. Leiman36 used ornidazole similarly. In our opinion, such short courses of higher doses are less well tolerated than conventional ones and their efficacy is inferior to a treatment lasting 8 to 10 days. Patients with amebic liver abscess respond favorably after 3 days of treatment. Up to 85% of recoveries are obtained if treatment is continued for at least 5 days, and 95% if treatment is extended to 10 days. Intravenous administration of metronidazole is highly effective in cases with severe forms of invasive amebiasis, such as multiple liver abscess, ameboma, amebic appendicitis, etc. The recommended dose is 500 mg every 6 h. Plasma concentration reaches 33.5 ± 3.2 mg/ml when metronidazole is intravenously administered. Metronidazole is also absorbed rectally and can therefore be eventually administered in the form of suppositories.
Dientamoeba fragilis Infection
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Candela Menéndez Fernández-Miranda, Jonathan Fernández Suarez, Noelia Moran Suarez, Javier Fernández Domínguez, María Martínez Sela, Mercedes Rodríguez Pérez, Azucena Rodríguez-Guardado
Secnidazole and ornidazole are 5-nitroimidazole derivatives. They have a longer half-life than metronidazole, so they can be administered in a single oral dose per day, and they have less side effects. Girginkardesler et al.72 studied the treatment of D. fragilis with secnidazole in 35 patients, being eradicated in 34 of them (97%). Ornidazole was used by Kurt et al.107 for the treatment of D. fragilis infection, and comparing with metronidazole, 112 patients were enrolled and randomized in two treatment groups: the first was treated with ornidazole in a single oral dose, and the second with metronidazole three times a day. They achieved parasitological eradication in 52 of 56 (92.9%) patients treated with ornidazole, and 39 of 56 (69.6%) patients treated with metronidazole. The four remaining patients of the ornidazole group were treated again with this drug, demonstrating parasite eradication. In the second group only 8 of the 17 remaining patients were cured with a second regimen, and the other nine had to receive a single oral dose of ornidazole to achieve eradication.
Metronidazole
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Fulminant hepatitis has been described in association with metronidazole rechallenge in a 24-year-old woman, resulting in coma and subsequent death. Two years prior to this presentation she had been treated with metronidazole, which was also complicated by hepatitis, and following this insult, her transaminase levels improved but remained abnormal. At autopsy her liver showed fulminant necrosis (Bjornsson et al., 2002). Another 36-year-old woman developed deranged liver function tests following 5 days of metronidazole treatment. A liver biopsy confirmed acute hepatitis. This patient was then treated with two further courses of ornidazole. After each course of ornidazole, she developed biochemical evidence of hepatitis in association with nausea, vomiting, and jaundice. Her liver function tests failed to return to normal. On each occasion, a liver biopsy was performed that showed chronic hepatitis with piecemeal necrosis (Ersoz et al., 2001).
The effect of povidone-iodine rectal cleansing on post-biopsy infectious complications
Published in Scandinavian Journal of Urology, 2023
Unfortunately, no data shows the rate of FQ-resistant E. coli in our region and hospital, and we do still use CİP + ORN as a prophylactic antibiotic before the biopsy. Because FQs are easy to use and ideally penetrate blood, urine, and prostate tissue. They are very effective against E. coli and anaerobes that cover the colon flora. As an augmented antibiotic prophylaxis strategy, ornidazole was added, which is effective against Klebsiella, Clostridium, and Bacteroides fragilis strains. They were commonly seen in patient’s blood and urine cultures after TRUS-P [23]. Other than augmented antibiotic prophylaxis, targeted antibiotic prophylaxis with rectal swab culture is another method to decrease biopsy-related infectious complications. In some studies [24,25], it has been shown that targeted antibiotic prophylaxis significantly reduces sepsis and infectious complication rates. On the other hand, some publications [26,27] reported that, although appropriate antibiotics were given to patients before the biopsy procedure, it was not superior to augmented antibiotic prophylaxis. Both authors of these studies [26,27] recommended a transperineal prostate biopsy.
Iatrogenic factors of Helicobacter pylori eradication failure: lessons from the frontline
Published in Expert Review of Anti-infective Therapy, 2023
Jinliang Xie, Dingwei Liu, Jianxiang Peng, Shuang Wu, Dongsheng Liu, Yong Xie
Patients used nitroimidazoles mainly included metronidazole, tinidazole and ornidazole. Quinolones mainly include levofloxacin, antofloxacin, and moxifloxacin. We evaluated whether the dose of bismuth, antibiotics, and PPI was appropriate or not according to the ‘Fifth Chinese national consensus report on the management of Helicobacter pylori infection’ [9]. Standard doses of various drugs are defined as follows: amoxicillin 1000 mg twice a day (b.i.d), clarithromycin 500 mg b.i.d, metronidazole 400 mg thrice a day (t.i.d) or four times a day (q.i.d), tetracycline 500 mg t.i.d or q.i.d, furazolidone 100 mg b.i.d, levofloxacin 500 mg q.d or 200 mg b.i.d, esomeprazole 20 mg b.i.d, omeprazole 20 mg b.i.d, lansoprazole 30 mg b.i.d, pantoprazole 40 mg b.i.d, ilaprazole 5 mg b.i.d, and bismuth potassium citrate 220 mg b.i.d.
The effect of abdominal drainage on post-operative morbidity; a prospective cohort study
Published in Journal of Obstetrics and Gynaecology, 2022
Serkan Akış, Esra Keleş, Uğur Kemal Öztürk, Cihat Murat Alınca, Yunus Emre Purut, Murat Api, Canan Kabaca
Gynaecologic oncological surgeries were performed by experienced gynaecologic oncologists and gynaecologic oncology fellows using minimally invasive or open approaches. A feeding tube was used as an intra-abdominal drain in laparoscopic surgeries, while a silicone redon drain was placed in laparotomies. All the patients underwent pre-operative bowel preparation including dietary modifications as well as the administration of 135 ml of B.T. Enema (sodium dihydrogen phosphate with disodium hydrogen phosphate) (Yenisehir Laboratory, Ankara, Turkey) and an oral laxative solution (two sachets of Sennoside daily in 250 ml of water) (Yenisehir Laboratory, Ankara, Turkey). Each patient was administered oral bowel preparation drugs. Oral ornidazole was administered at 1 g per day (2 tablets per day). Pharmacological venous thromboembolism (VTE) prophylaxis was administered 12 h pre-operatively, and 2 g of intravenous prophylactic cefazolin was injected before anaesthesia induction. All patients underwent pre-operative biochemical and hematological tests, chest radiography, and electrocardiography.