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Metronidazole (Flagyl) versus Other Medications
Metronidazole (Flagyl) vs. Ciprofloxacin
(Cipro)
- Pouchitis
Ciprofloxacin is preferable to metronidazole1,
because treatment with ciprofloxacin eradicates both pathogens (Clostridium
perfringens and E. coli ) and results in an optimal restoration of
normal pouch flora. Also, ciprofloxacin is better tolerated than metronidazole2.
Metronidazole (Flagyl) vs. Albendazole
- Giardiasis
Albendazole and metronidazole are equally effective in the treatment
of giardiasis3-4. Albendazole
is better tolerated than metronidazole.
Metronidazole (Flagyl) vs. Vancomycin
- Clostridium difficile-associated diarrhea
Metronidazole and vancomycin are equally effective for the treatment
of mild Clostridium difficile-associated diarrhea (CDAD), but vancomycin
is superior for treating severe CDAD5.
Further reading
References
- 1. Gosselink MP, Schouten WR, van Lieshout LM,
Hop WC, Laman JD, Ruseler-van Embden JG. Eradication of pathogenic
bacteria and restoration of normal pouch flora: comparison of metronidazole
and ciprofloxacin in the treatment of pouchitis. Dis Colon Rectum.
2004 Sep;47(9):1519-25. Epub 2004 Jul 8. PubMed
- 2. Shen B, Achkar JP, Lashner BA, Ormsby AH,
Remzi FH, Brzezinski A, Bevins CL, Bambrick ML, Seidner DL, Fazio
VW. A randomized clinical trial of ciprofloxacin and metronidazole
to treat acute pouchitis. Inflamm Bowel Dis. 2001 Nov;7(4):301-5.
PubMed
- 3. Romero-Cabello R, Robert L, Munoz-Garci'a
R, Tanaka J. Randomized study comparing the safety and efficacy of
albendazole and metronidazole in the treatment of giardiasis in children.
Rev Latinoam Microbiol. 1995 Oct-Dec;37(4):315-23. PubMed
- 4. Misra PK, Kumar A, Agarwal V, Jagota SC. A
comparative clinical trial of albendazole versus metronidazole in
giardiasis. Indian Pediatr. 1995 Mar;32(3):291-4. PubMed
- 5. Zar FA, Bakkanagari SR, Moorthi KM, Davis
MB. A comparison of vancomycin and metronidazole for the treatment
of Clostridium difficile-associated diarrhea, stratified by disease
severity. Clin Infect Dis. 2007 Aug 1;45(3):302-7. Epub 2007 Jun 19.
PubMed
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