Metronidazole and Tinidazole clinical use

Metronidazole or tinidazole is the drug of choice in severe intestinal wall disease and in hepatic abscess and other extraintestinal amebic disease. Both drugs are used with a luminal amebicide. The duration of treatment required with metronidazole is longer than with tinidazole. Metronidazole is the drug of choice for trichomoniasis: tinidazole may be effective against some metronidazole-resistant organisms. Other clinical uses of metronidazole include treatment of giardiasis (tinidazole is equally effective), and infections caused by Gardnerella vaginalis and anaerobic bacteria (B fragilis, C difficile). Metronidazole is also used in combination regimens for gastrointestinal ulcers associated with H pylori. Metronidazole a nitroimidazole, is the mixed amebicide of choice for treating amebic infections and kills the E. histolytica trophozoites. [Note: Metronidazole also finds extensive use in the treatment of infections caused by anaerobic cocci, and anaerobic gramnegative bacilli (for example, Bacteroides species). Metronidazole is the drug of choice for the treatment of pseudomembranous colitis caused by the anaerobic, gram-positive bacillus Clostridium difficile and is also effective in the treatment of brain abscesses caused by these organisms.]