Metronidazole 0.5% w/v IV Infusion – Complete Guide: Uses, Dosage, Side Effects & Precautions

 

Metronidazole 0.5% w/v IV Infusion is a potent antimicrobial medication widely prescribed to treat serious anaerobic bacterial infections and certain protozoal infections. Administered intravenously, it ensures rapid absorption and immediate action, making it essential for severe or systemic infections.

What is Metronidazole IV Infusion?

Generic Name: Metronidazole

Strength: 0.5% w/v (5 mg/mL)

Formulation: 100 mL intravenous infusion containing 500 mg of metronidazole

Route of Administration: Intravenous (IV)

Metronidazole is a nitroimidazole antibiotic that works by inhibiting the DNA synthesis of anaerobic bacteria and protozoa, ultimately killing the pathogens. It is particularly effective in areas of the body where oxygen levels are low, such as the gastrointestinal tract, abscesses, and deep tissue infections.

Medical Uses of Metronidazole IV Infusion

Metronidazole IV is used to manage a wide variety of infections, including:

1. Anaerobic Bacterial Infections

Intra-abdominal infections: peritonitis, appendicitis, liver abscess

Septicemia: blood infections caused by anaerobic bacteria

Bone and joint infections: osteomyelitis

Central nervous system infections: brain abscesses, meningitis

Gynecological infections: endometritis, pelvic inflammatory disease, pelvic abscess

Post-operative infections: after surgeries prone to anaerobic bacterial infections

2. Protozoal Infections

Amoebiasis (Entamoeba histolytica)

Giardiasis (Giardia lamblia)

Trichomoniasis (Trichomonas vaginalis)

3. Surgical Prophylaxis

Prevents anaerobic infections during abdominal or gynecological surgeries.

Dosage and Administration

Adults:

Standard dose: 500 mg IV every 8 hours

Infusion time: Administer over 20–60 minutes to reduce side effects

Children:

Dose: 7.5 mg/kg IV every 8 hours

Dosage must be carefully calculated based on age and weight

Special considerations:

Elderly patients: Monitor renal and hepatic function

Renal or hepatic impairment: Dose adjustment may be necessary

Always follow the prescription given by a healthcare professional

Contraindications

Metronidazole IV should not be used in patients with:

Known hypersensitivity to metronidazole or other nitroimidazoles

First trimester of pregnancy (unless absolutely necessary)

Severe liver disease

Side Effects

Common side effects:

Nausea, vomiting, diarrhea

Metallic taste in the mouth

Abdominal discomfort

Headache, dizziness

Rare but serious side effects:

Seizures or peripheral neuropathy

Blood disorders such as leukopenia with prolonged therapy

Severe allergic reactions (rash, itching, swelling, anaphylaxis)

Important note: Alcohol should be strictly avoided during therapy and for at least 72 hours after the last dose, as it may cause disulfiram-like reactions (flushing, vomiting, palpitations).

Pharmacology

Mechanism of action: Metronidazole is bactericidal and protozoacidal. It interferes with the DNA of anaerobic microorganisms, inhibiting nucleic acid synthesis and resulting in cell death.

Absorption & distribution: Rapidly distributed in plasma; penetrates CNS, liver, lungs, saliva, and breast milk.

Metabolism: Primarily metabolized in the liver.

Excretion: 60–80% excreted via urine.

Precautions and Monitoring

Monitor liver and kidney function in patients with impairment

Prolonged use may require blood count monitoring

Pregnant and breastfeeding women: Use only if prescribed by a physician

Pediatric patients: Dose carefully calculated based on age and weight

Avoid concomitant alcohol consumption

Monitor for neurological symptoms during long-term therapy

How to Administer

Use single-use IV infusion bags only

Administer slowly over 20–60 minutes

Do not mix with other medications in the same infusion bag

Storage

Store below 25°C

Protect from light

Use immediately after opening; do not store leftover solution

 

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