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5.1 Antibacterial drugs
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5.1.1 Penicillins
5.1.2 Cephalosporins, carbapenems, and other beta-lactams
5.1.3 Tetracyclines
5.1.4 Aminoglycosides
5.1.5 Macrolides
5.1.6 Clindamycin
5.1.7 Some other antibacterials
5.1.8 Sulfonamides and trimethoprim
5.1.9 Antituberculosis drugs
5.1.10 Antileprotic drugs
5.1.11 Nitroimidazole derivatives
5.1.12 Quinolones
5.1.13 Urinary-tract infections
Chapter 5: Infections
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Principles of antibacterial treatment
Upper respiratory tract infections
Lower respiratory tract infections
Acute exacerbation of bronchiectasis (non-cystic fibrosis)
Urinary tract infections (UTI)
Gastro-intestinal tract infections
Genital tract infections
Skin and soft tissue infections
Eye infections
Oral and dental infections
Lyme disease guidance
Meningitis guidance
Methicillin Resistant Staphylococcus Aureus (MRSA) guidance
COVID-19 treatments for patients who do not require hospitalisation
5.1 Antibacterial drugs
5.2 Antifungal drugs
5.3 Antiviral drugs
5.4 Antiprotozoal drugs
5.5 Anthelmintics
Page last updated:
21 December 2021
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5.1.11 Nitroimidazole derivatives
First Line
Second Line
Specialist
Hospital Only
Alcohol should be avoided during and for 72 hours after tinidazole and at least 48 hours after metronidazole treatment, because of the possibility of a disulfiram-like reaction (flushing, abdominal cramps, vomiting, tachycardia).
Metronidazole
- Tablets 200mg, 400mg (£4.03 = 21 x 200mg tablets, £1.03 = 21 x 400mg tablets)
- Oral suspension 200mg/5ml (£62.36 = 100ml)
- Suppositories 500mg, 1g (£15.18, £23.06 = 10)
- Intravenous infusion 500mg/100ml
Indications
- Acute necrotising ulcerative gingivitis
- Bacterial vaginosis
- Bites (animal and human) - with doxycycline (second line)
- Clostridioides difficile (C. difficile) (first episode, mild cases only - second line)
- Dental abscess
- Eradication of H. pylori
- Giardiasis
- Pelvic inflammatory disease
- plus ceftriaxone IM and doxycycline or
- plus doxycycline (second line) (oral regime only)
- Pericoronitis
- Trichomoniasis
Notes
- Metronidazole oral suspension is not recommended for C. difficile infection (theoretical risk that efficacy of metronidazole benzoate may be compromised because of reduced exposure to gastric enzymes)
Tinidazole
- Tablets 500mg (unlicensed special)
Indications
