Metronidazole, a potent antibiotic, is the go-to treatment for combating anaerobic bacterial infections and certain parasites. According to the Centers for Disease Control and Prevention (CDC), this medication is crucial in the fight against bacterial vaginosis, a condition affecting 29.2% of women aged 14-49 in the U.S. While metronidazole is not the primary treatment for urinary tract infections (UTIs), it can be prescribed when UTIs are caused by anaerobic bacteria, which are less common. The drug's mechanism is precise; it disrupts DNA synthesis and protein formation in harmful bacteria, leading to cell death. By focusing on the underlying cause, metronidazole ensures a targeted approach to infection management, offering patients a reliable solution to their ailment.
While metronidazole was not designed to fight urinary tract infections, it is sometimes prescribed to treat cases of reoccurring and persistent nongonococcal urethritis. When used as directed, metronidazole can eliminate urethritis-causing bacteria within seven days. Before using metronidazole for urinary tract infections, patients should discuss dosage and possible side effects with their physician.
Common Uses of Metronidazole
There are several common uses of metronidazole. This medication is commonly used to treat vaginal, skin, stomach, heart, blood, joints, and bone infections. Physicians usually only prescribe metronidazole for urinary tract infections when patients are suffering from a particularly resistant case of nongonococcal urethritis.
The drug gets used for various health conditions without considering associated neurotoxicity. More uses include:
Stomach and Intestinal Infections
Metronidazole is a standard treatment method for intestinal infections such as amoebic colitis (dysentery). Helicobacter pylori (H.pylori) infection causes gastric ulcers for which metronidazole aids. Metronidazole is a home drug for stomach infections and ulcers.
Frequent drug use for stomach ulcers has drastically increased metronidazole resistance in the population. Metronidazole therapy is very effective against fulminating and non-fulminating Clostridium difficile infection.
Oral or Dental Infections
Dentists across the globe prescribe amoxicillin and metronidazole for treating acute dentoalveolar infections. Studies suggest that this particular regimen is more effective than azithromycin therapy.
Heart Infections
The medicine also treats inflammation of the heart's valves. A case of heart valve inflammation, known as endocarditis, due to Veillonella parvula (bacterium) was successfully treated with metronidazole.
It also gets used as a prophylactic antibiotic in cases of a prosthetic heart valve to prevent infective endocarditis.
Infections of Vagina
We commonly treat a vaginal infection by bacteria using metronidazole. As per studies, the drug showed promising results in eradicating Trichomonas vaginalis infestation. The ideal dose for treating bacterial vaginosis is oral metronidazole (500mg) daily for a week.
Urinary Tract Infections (UTIs)
As the name indicates, urinary tract infections involve the organs connected to the urinary tract. This includes parts of the urinary system, i.e., the urethra, bladder, and kidneys. The condition is more common in women than men. That is because women have a shorter urethra that is more prone to acquiring a bacterial infection.
The prevalence of UTIs occur in approximately 20% of women aged 65 years or above. In most cases, bacteria in the stool enter the urinary tract and cause infection.
The most common symptoms of a urinary tract infection include burning pee, frequent peeing at night, and smelly, dark-colored pee. Changes in urine color and smell are usually associated with tummy pain and fever. Some patients have also reported blood in the pee (hematospermia).
The main culprit in UTIs is E.coli. The spread of the bacteria to the kidneys can cause havoc. Therefore, it is necessary to treat it as soon as possible. Complications associated with UTI include acute polynephritis (kidney infection), cystitis (bladder inflammation), and urethritis (urethral inflammation).
Treating Urinary Tract Infection With Metronidazole
The drug is not commonly used for Urinary Tract Infection treatment. However, metronidazole combined with cefuroxime helps prevent urinary tract infections in women undergoing hysterectomy.
Another bacterial strain that can cause vaginosis in women and UTI in men is Gardrenella vaginosis. Oral metronidazole therapy reduced preterm births in women with excessive G.vaginalis growth (bacterial vaginosis).
However, metronidazole is not effective in eradicating the bacteria colonies. An adherent biofilm of Gardnerella vaginalis persisted even after oral metronidazole therapy.
Resitance to Nongonococcal Uretheritis
Urethritis is a urinary tract infection that only affects the urethra. In uncomplicated cases of urethritis, certain antibiotics are usually used to fight the infection. If these medications are ineffective or if the infection keeps returning, a physician may decide to use metronidazole for urinary tract infections.
According to a randomized controlled trial, adding metronidazole to the medicinal regimen improved symptoms of urethritis in men with Trichomonas vaginalis infection.
Metronidazole combined with azithromycin or doxycycline works well in treating non-gonococcal urethritis. However, metronidazole is not used to treat urinary tract infections that have traveled to the kidneys or bladder.
Metronidazole is most effective when combined with either erythromycin or erythromycin ethyl succinate. These medications should be used for seven days to treat reoccurring urethritis. After completing seven days of treatment, the patient’s symptoms should be eliminated.
Patients must follow all metronidazole dosage instructions as given by their physician. Missing doses or failing to finish the prescription will negatively impact the effectiveness of the medication.
Infections caused by Chlamydia trachomatis or diplococci bacteria will not respond to metronidazole. The medicine is also ineffective when treating gonococcal urethritis. If a patient believes that he or she might be suffering from a gonorrheal infection, this issue will need to be eliminated before treating urethritis.
Metronidazole Drug Interactions
Before taking metronidazole, patients should let their physicians know about any medications or herbal supplements they are taking. Certain medications, such as cimetidine and phenytoin, may impact the effectiveness and safety of metronidazole.
Pregnant women and those who are nursing should also avoid this medication.
It can also interact with alcohol-containing products such as cough syrups. You should avoid taking metronidazole if you have taken disulfiram, a drug used to treat alcohol addiction.
Metronidazole Side Effects
Patients should also be aware of specific metronidazole side effects. Metronidazole may cause stomach pain, cold-like symptoms, dizziness, dry mouth, vaginal itching, and swelling of the tongue. More serious side effects include fever, hives, seizures, painful urination, mood swings, vision problems, and swelling of the face, throat, or tongue.
Mild-to-moderate side effects of metronidazole are well-tolerated. However, severe complications like nephrotoxicity should be managed medically. If a patient experiences these side effects, he or she should seek immediate medical attention.
Metronidazole is usually very effective when used as directed in treating persistent, nongonococcal urinary tract infections.
How to Prevent Urinary Tract Infections
Urinary tract infections can lead to complications and require extensive antibiotic therapy for treatment. Thus, it is better to prevent infection. You can reduce the risk of urinary tract infections by drinking copious amounts of water. Large amounts of water flush out bacteria from the tract.
By drinking cranberry juice, you can change the pH of your urine, making it difficult for bacteria to thrive. Emptying the bladder by peeing after sexual intercourse and taking care of vaginal sanitation can also help prevent UTIs.