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Treatment and Prevention of Amebiasis
Published in Roberto R. Kretschmer, Amebiasis: Infection and Disease by Entamoeba histolytica, 2020
Chemical structure — Metronidazole is the 1-(β-hydroxyethyl) 2-methyl-5-nitroimi-dazole, derived from 2-nitroimidazole. The structure is shown in Figure 3. Many nitroimidazoles of similar structure and activity are now in use. They include trinidazole, flunidazole, ronidazole, dimetridazole, and satranidazole. Some patients respond poorly to metronidazole. This has been observed in subjects undergoing treatment with phenobarbital, such as epileptic children.28 A possible explanation is a shortening of the half-life of metronidazole29 resulting from a more intense hydroxylation due to the excessive stimulation of microsomal enzymes by this barbiturate.
Vulval Ulceration
Published in Tony Hollingworth, Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
The vulva and perineum may be affected in up to 30 per cent of patients, and this may pre-date gastrointestinal symptoms. The vulval skin is oedematous with ulcers which appear like knife cuts in the skin; however, discharging sinuses and irregular ulcers are more common. Treatment is usually with met-ronidazole and immunomodulators; surgery should be avoided. This problem is rarely seen by gynaecologists. Access www.crohns.org.uk for further information.
Clostridioides difficile: innovations in target discovery and potential for therapeutic success
Published in Expert Opinion on Therapeutic Targets, 2021
Tanya M Monaghan, Anna M Seekatz, Benjamin H Mullish, Claudia C. E. R Moore-Gillon, Lisa F. Dawson, Ammar Ahmed, Dina Kao, Weng C Chan
Ronidazole (8; Figure 2) is a veterinary antiprotozoal drug which like DIHQ can inhibit the growth of clinical C. difficile isolates, whilst preserving the growth of several commensal organisms in the human intestine. Ronidaxole was superior to metronidazole when both were tested at a dose of 1 mg/kg daily in a mouse model of CDI [128]. Like metronidazole, ronidazole is a member of the antibiotic class of nitroimidazole [128]. Hence, it is anticipated that the nitro group is reduced by the clostridial pyruvate:ferredoxin oxidoreductase to produce imidazole radical and nitrite, both of which are capable of causing damage to the bacterial DNA leading to cell death.