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Topic:Metronidazole

Metronidazole is an antimicrobial agent commonly used in equine medicine to treat infections caused by anaerobic bacteria and certain protozoal infections. It is often administered in cases of gastrointestinal disturbances, including colitis, due to its efficacy against anaerobic pathogens. The drug works by disrupting the DNA of the microorganisms, leading to their death. Metronidazole is available in various formulations, and its administration must be carefully managed to avoid potential side effects such as neurological symptoms. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacokinetics, therapeutic applications, and safety considerations of metronidazole in horses.
Clostridioides difficile infection in thoroughbred horses in Japan from 2010 to 2021.
Scientific reports    August 11, 2023   Volume 13, Issue 1 13099 doi: 10.1038/s41598-023-40157-x
Uchida-Fujii E, Niwa H, Senoh M, Kato H, Kinoshita Y, Mita H, Ueno T.We encountered 34 Clostridioides difficile (C. difficile) infection (CDI) cases among Thoroughbred horses in Japan from 2010 to 2021. Among them, 79.4% (27/34) either died or were euthanised. The risk factors associated with CDI and mortality among Japanese Thoroughbred horses remain unclear. We used genetic methods to examine C. difficile strains and their relationships with prognosis. Twenty-two (64.7%) cases were hospitalised at the onset of colitis. Outcomes were balanced for hospitalisation rates at the onset of colitis. The mortality rates of cases treated with metronidazole (65.0%) were...
Simultaneous Daily Fecal Microbiota Transplantation Fails to Prevent Metronidazole-Induced Dysbiosis of Equine Gut Microbiota.
Journal of equine veterinary science    May 6, 2022   Volume 114 104004 doi: 10.1016/j.jevs.2022.104004
Kinoshita Y, Niwa H, Uchida-Fujii E, Nukada T, Ueno T.Antimicrobial administration can lead to imbalances of gastrointestinal microbiota, called dysbiosis. Dysbiosis sometimes results in diarrhea and enteritis in horses. Fecal microbiota transplantation (FMT) is used to treat affected horses, but whether it is effective as a prophylactic approach for dysbiosis in horses receiving antimicrobials remains unknown. The aim of this study was to assess the efficacy of simultaneous FMT against metronidazole-induced dysbiosis in horses. Changes in the ratios of bacterial families, determined by metagenomic analysis, were similar between the metronidazole...
The Concentration of Metronidazole in the Distal Interphalangeal Joint following Intravenous Regional Limb Perfusion via the Cephalic Vein in Standing Horses.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    May 12, 2021   Volume 34, Issue 4 287-293 doi: 10.1055/s-0041-1726083
Gustafsson K, Tatz AJ, Dahan R, Britzi M, Soback S, Ahmad WA, Prince H, Kelmer G. The aim of this study was to determine the concentration of metronidazole in the distal interphalangeal joint (DIPJ) of the thoracic limb after administering metronidazole to standing horses by intravenous regional limb perfusion (IVRLP). Methods:  Eleven healthy horses had a wide rubber tourniquet applied to the proximal aspect of the antebrachium for 0.5 hours and 500 mg of metronidazole diluted in physiologic saline solution to a total volume of 108 mL was administered by cephalic IVRLP. Synovial fluid samples were collected from the DIPJ before perfusion and at 0.25, 0.5, 2, 12 ...
Meningitis After Tooth Extraction and Sinus Lavage in a Horse.
Journal of equine veterinary science    November 16, 2020   Volume 97 103323 doi: 10.1016/j.jevs.2020.103323
Zetterström S, Groover E, Lascola K, Cole R, Velloso A, Boone L.A five-year-old Thoroughbred mare was evaluated because of chronic, malodorous, unilateral nasal discharge, and suspected maxillary cheek tooth root abscess. Skull radiographs revealed bilateral sinusitis suspected secondary to tooth root abscessation of 109 and 210. Following oral extraction of 109, bilateral conchofrontal sinus trephination and lavage; fever, tachycardia, and cervical stiffness developed. A lumbosacral cerebrospinal fluid tap was performed, and a presumptive diagnosis of bacterial meningitis was made. Targeted therapy consisted of antibiotic treatment with penicillin, enrofl...
Single-dose pharmacokinetics of orally administered metronidazole and intravenously administered imipenem in healthy horses and computer-based simulation of pleural fluid concentrations with multiple dosing.
American journal of veterinary research    September 25, 2020   Volume 81, Issue 10 783-789 doi: 10.2460/ajvr.81.10.783
Kuroda T, Nagata SI, Tamura N, Kinoshita Y, Niwa H, Mita H, Minami T, Fukuda K, Hobo S, Kuwano A.To determine plasma pharmacokinetics of metronidazole and imipenem following administration of a single dose PO (metronidazole, 15 mg/kg) or IV (imipenem, 10 mg/kg) in healthy Thoroughbreds and simulate pleural fluid concentrations following multiple dose administration every 8 hours. Methods: 4 healthy Thoroughbreds. Methods: Metronidazole and imipenem were administered, and samples of plasma and pleural fluid were collected at predetermined time points. Minimum concentrations of metronidazole and imipenem that inhibited growth of 90% of isolates (MIC90), including 22 clinical Bacteroides iso...
The cecal and fecal microbiomes and metabolomes of horses before and after metronidazole administration.
PloS one    May 22, 2020   Volume 15, Issue 5 e0232905 doi: 10.1371/journal.pone.0232905
Arnold CE, Isaiah A, Pilla R, Lidbury J, Coverdale JS, Callaway TR, Lawhon SD, Steiner J, Suchodolski JS.Antibiotic administration can be a cause of gastrointestinal disease in horses, creating a disruption in the normal population and function of bacteria found in the hindgut. The objective of this study was to describe the changes in the cecal and fecal microbiomes and metabolomes of clinically healthy horses before and after metronidazole administration. Metronidazole (15 mg/kg BID PO) was given to five horses with cecal cannulas. The study was suspended on Day 3 due to adverse gastrointestinal effects. Cecal and fecal samples were obtained before (Days minus52, m28, m14, and 0) and after (Day...
Rectal administration of metronidazole with and without rectal evacuation prior to use in horses.
Journal of veterinary pharmacology and therapeutics    July 20, 2018   Volume 41, Issue 6 838-842 doi: 10.1111/jvp.12697
Stein F, Gilliam L, Davis J, Taylor J.In a randomized crossover design study, 10 adult horses were administered crushed metronidazole tablets rectally at 20 mg/kg. Horses' rectums were either evacuated (E) or not evacuated (NE) of manure prior to the administration of the drug. Serum samples were taken over 24 hr and plasma concentrations were determined via high pressure liquid chromatography. At 15 min post-administration, group E had a significantly higher plasma concentration (p = 0.027), but there were no concentration differences at any other time points. There was large variability in relative bioavailability in the NE...
Analysis of metronidazole in equine plasma using liquid chromatography/tandem mass spectrometry and high-resolution accurate mass spectrometry.
Rapid communications in mass spectrometry : RCM    September 26, 2015   Volume 29, Issue 8 753-763 doi: 10.1002/rcm.7158
Ilomuanya M, Uboh C, Ciallella J, Li X, Liu Y, Ifudu N, Azubuike C, Igwilo C.Treatment of racehorses with bicarbonate solutions to manage acidosis and muscle cramps prior to competition is banned in Pennsylvania (PA). Use of excess bicarbonate in horses causes diarrhea, requiring treatment with an antibiotic such as metronidazole (MTNZ). At present no method exists for detecting MTNZ in equine plasma. Thus, a liquid chromatography/tandem mass spectrometry (LC/MS/MS) method for the detection, quantification and confirmation of MTNZ was developed. Methods: The analyte was recovered from plasma by liquid-liquid extraction using methyl tert-butyl ether and separated on an ...
Pharmacokinetics of metronidazole in foals: influence of age within the neonatal period.
Journal of veterinary pharmacology and therapeutics    October 1, 2014   Volume 38, Issue 3 227-234 doi: 10.1111/jvp.12164
Swain EA, Magdesian KG, Kass PH, Edman JE, Knych HK.Neonatal foals have unique pharmacokinetics, which may lead to accumulation of certain drugs when adult horse dosage regimens are used. Given its lipophilic nature and requirement for hepatic metabolism, metronidazole may be one of these drugs. The purpose of this study was to determine the pharmacokinetic profiles of metronidazole in twelve healthy foals at 1-2.5 days of age when administered as a single intravenous (IV) and intragastric (IG) dose of 15 mg/kg. Foals in the intravenous group were studied a second time at 10-12 days of age to evaluate the influence of age on pharmacokinetics wi...
Frequency of resistance in obligate anaerobic bacteria isolated from dogs, cats, and horses to antimicrobial agents.
Journal of clinical microbiology    September 11, 2013   Volume 51, Issue 11 3804-3810 doi: 10.1128/JCM.01432-13
Lawhon SD, Taylor A, Fajt VR.Clinical specimens from dogs, cats, and horses were examined for the presence of obligate anaerobic bacteria. Of 4,018 specimens cultured, 368 yielded 606 isolates of obligate anaerobic bacteria (248 from dogs, 50 from cats, and 308 from horses). There were 100 specimens from 94 animals from which only anaerobes were isolated (25 dogs, 8 cats, and 61 horses). The most common sites tested were abdominal fluid (dogs and cats) and intestinal contents (horses). The most common microorganism isolated from dogs, cats, and horses was Clostridium perfringens (75, 13, and101 isolates, respectively). Th...
Clostridium difficile in horses in Australia–a preliminary study.
Journal of medical microbiology    March 24, 2011   Volume 60, Issue Pt 8 1188-1192 doi: 10.1099/jmm.0.030908-0
Thean S, Elliott B, Riley TV.During a 24 month period from 2007 to 2009, 174 faecal specimens from horses in Australia (predominantly from Western Australia) were tested for Clostridium difficile. C. difficile was isolated from 14 (23 %) of 62 diarrhoeal animals (including 10 foals) and from none of 112 healthy adult horses. These isolates were toxin profiled by PCR for toxin A, toxin B and binary toxin, and ribotyped. Ten of the equine isolates were A(+)B(+)CDT(-). Other toxin profiles detected were A(-)B(-)CDT(+) (one isolate), A(+)B(+)CDT(+) (two isolates) and A(-)B(-)CDT(-) (three isolates). There were six different...
Bioavailability and pharmacokinetics of metronidazole in fed and fasted horses.
Journal of veterinary pharmacology and therapeutics    September 24, 2010   Volume 33, Issue 5 511-514 doi: 10.1111/j.1365-2885.2010.01171.x
Britzi M, Gross M, Lavy E, Soback S, Steinman A.No abstract available
Evaluation of in vitro properties of di-tri-octahedral smectite on clostridial toxins and growth.
Equine veterinary journal    December 3, 2003   Volume 35, Issue 7 638-641 doi: 10.2746/042516403775696384
Weese JS, Cote NM, deGannes RV.Clostridial colitis and endotoxaemia of intestinal origin are significant causes of morbidity and mortality in horses. Intestinal adsorbents are available for treatment of these conditions; however, little information exists supporting their use. Objective: To evaluate the ability of di-tri-octahedral smectite to bind to Clostridium difficile toxins A and B, C. perfringens enterotoxin and endotoxin, inhibit clostridial growth and the actions of metronidazole in vitro. Methods: Clostridium difficile toxins, C. perfringens enterotoxin and endotoxin were mixed with serial dilutions of di-tri-octa...
Clostridium difficile: prevalence in horses and environment, and antimicrobial susceptibility.
Equine veterinary journal    July 24, 2003   Volume 35, Issue 5 465-471 doi: 10.2746/042516403775600505
Båverud V, Gustafsson A, Franklin A, Aspán A, Gunnarsson A.Clostridium difficile has been associated with acute colitis in mature horses. Objective: To survey C. difficile colonisation of the alimentary tract with age, occurrence of diarrhoea and history of antibiotic therapy; and to study the occurrence and survival of C. difficile in the environment and antimicrobial susceptibility of isolated strains. Methods: A total of 777 horses of different breeds, age and sex were studied. Further, 598 soil samples and 434 indoor surface samples were examined. Antimicrobial susceptibility of 52 strains was investigated by Etest for 10 antibiotics. Results: In ...
Characterization of Clostridium difficile isolates from foals with diarrhea: 28 cases (1993-1997).
Journal of the American Veterinary Medical Association    April 12, 2003   Volume 220, Issue 1 67-73 doi: 10.2460/javma.2002.220.67
Magdesian KG, Hirsh DC, Jang SS, Hansen LM, Madigan JE.To determine molecular characteristics of Clostridium difficile isolates from foals with diarrhea and identify clinical abnormalities in affected foals. Methods: Retrospective study. Methods: 28 foals with C difficile-associated diarrhea. Methods: Toxigenicity, molecular fingerprinting, and antibiotic susceptibility patterns were determined. Information on signalment, clinical findings, results of clinicopathologic testing, whether antimicrobials had been administered prior to development of diarrhea, and outcome was obtained from the medical records. Results: Twenty-three (82%) foals survived...
Pharmacokinetics of metronidazole in horses after intravenous, rectal and oral administration.
Journal of veterinary pharmacology and therapeutics    February 13, 2001   Volume 23, Issue 6 353-357 doi: 10.1046/j.1365-2885.2000.00294.x
Steinman A, Gips M, Lavy E, Sinay I, Soback S.Metronidazole pharmacokinetics in horses was studied after intravenous (i.v.), rectal (p.r.) and oral (p.o.) administration at 20 mg/kg using a triple crossover study design. Metronidazole mean+/-SD half-life was 196+/-39, 212+/-30 and 240+/-65 min after i.v., p.r. and p.o. administration, respectively. The metronidazole clearance was 2.8 (mL/min/kg) and the volume of distribution at steady state was 0.68 L/kg. The pharmacokinetic parameters calculated for metronidazole after administration of the drug by the various routes showed that bioavailability (74+/-18 vs. 30+/-9%) and maximum serum co...
Association of Clostridium difficile with enterocolitis and lactose intolerance in a foal.
Journal of the American Veterinary Medical Association    February 2, 1999   Volume 214, Issue 2 229-205 
Weese JS, Parsons DA, Staempfli HR.Diagnoses of Clostridium difficile enterocolitis and lactose intolerance were made in a neonatal foal with persistent diarrhea. It was determined that the foal had lactose intolerance on the basis of the results of a lactose tolerance test, and a diagnosis of C difficile enterocolitis was subsequently made. The foal responded to oral administration of metronidazole and lactase. Lactose intolerance is a secondary problem most commonly associated with rotavirus infection, but it can be caused by any condition affecting the small intestine. Because C difficile can affect the small intestine in fo...
Use of metronidazole in horses.
The Veterinary record    August 12, 1998   Volume 143, Issue 1 27 
Rutter JM.No abstract available
Use of metronidazole in horses.
The Veterinary record    July 22, 1998   Volume 142, Issue 24 675 
Dyson SJ, Jones RD, Ricketts SW.No abstract available
Use of metronidazole in horses.
The Veterinary record    July 22, 1998   Volume 142, Issue 25 704 
Sanford J.No abstract available
Use of metronidazole in equine acute idiopathic toxaemic colitis.
The Veterinary record    July 3, 1998   Volume 142, Issue 23 635-638 doi: 10.1136/vr.142.23.635
McGorum BC, Dixon PM, Smith DG.Sixteen cases of acute idiopathic toxaemic colitis developed in a veterinary hospital over a period of three years. Before the onset of colitis, 15 horses had received antibiotics, 11 had undergone general anaesthesia and various surgical procedures, and 10 had been treated with non-steroidal anti-inflammatory drugs. The horses had acute onset, profuse watery diarrhoea, profound depression, mild to moderate abdominal pain, reduced intestinal borborygmi, tachycardia, dehydration and endotoxic shock. Leucopenia, neutropenia and pyrexia were common early indicators of impending colitis. Metronida...
Antimicrobial susceptibilities of equine isolates of Clostridium difficile and molecular characterization of metronidazole-resistant strains.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America    October 6, 1997   Volume 25 Suppl 2 S266-S267 doi: 10.1086/516235
Jang SS, Hansen LM, Breher JE, Riley DA, Magdesian KG, Madigan JE, Tang YJ, Silva J, Hirsh DC.No abstract available
Pharmacokinetics of metronidazole after rectal administration in horses.
American journal of veterinary research    December 1, 1993   Volume 54, Issue 12 2060-2063 
Garber JL, Brown MP, Gronwall RR, Merritt K.Five healthy adult mares and 1 gelding were given a single dose (15 mg/kg of body weight) of metronidazole per rectum. After manual evacuation of feces from the rectum, a suspension of crushed tablets and water (40 ml) was administered via a 28-F catheter advanced 30 cm into the rectum. Blood samples were obtained by jugular venipuncture, and metronidazole concentration was measured serially for the 14 hours after drug administration. Mean serum concentration of metronidazole peaked at 4.5 micrograms/ml, 0.83 hour after administration, and decreased to 0.38 microgram/ml, 14 hours after adminis...
Pharmacokinetics of metronidazole and its concentration in body fluids and endometrial tissues of mares.
American journal of veterinary research    October 1, 1992   Volume 53, Issue 10 1807-1812 
Specht TE, Brown MP, Gronwall RR, Rib WJ, Houston AE.Serum concentrations of metronidazole were determined in 6 healthy adult mares after a single IV injection of metronidazole (15 mg/kg of body weight). The mean elimination rate (K) was 0.23 h-1, and the mean elimination half-life (t1/2) was 3.1 hours. The apparent volume of distribution at steady state was 0.69 L/kg, and the clearance was 168 ml/h/kg. Each mare was then given a loading dose (15 mg/kg) of metronidazole at time 0, followed by 4 maintenance doses (7.5 mg/kg, q 6 h) by nasogastric tube. Metronidazole concentrations were measured in serial samples of serum, synovia, peritoneal flui...
Clinical use of metronidazole in horses: 200 cases (1984-1989).
Journal of the American Veterinary Medical Association    March 15, 1991   Volume 198, Issue 6 1045-1048 
Sweeney RW, Sweeney CR, Weiher J.Case records of 200 horses treated with metronidazole were reviewed. Horses were treated for respiratory tract infections (90 cases), peritonitis or abdominal abscess (39 cases), celiotomy (49 cases), orthopedic infections (6 cases), and miscellaneous soft tissue infections (16 cases). Bacteria of the genus Bacteroides were most prevalent (55 of 167 anaerobic isolates). Metronidazole was always used in combination with other antimicrobial drugs. Only 4 of the 200 horses had signs of adverse effects associated with metronidazole treatment. Those 4 horses had poor appetite that resolved when met...
Anaerobic bacterial pneumonia with septicemia in two racehorses.
Journal of the American Veterinary Medical Association    March 15, 1990   Volume 196, Issue 6 941-943 
Carlson GP, O'Brien MA.Anaerobic bacterial pneumonia with septicemia was diagnosed in 2 Thoroughbred racehorses referred with respiratory tract disease that had failed to respond to initial treatment with various antibiotics including penicillin and trimethoprim-sulfamethoxazole. Multiple anaerobic organisms, including Bacteroides spp and Fusobacterium spp, were isolated from blood and transtracheal aspirates obtained from both horses and from aspirates of cutaneous nodules obtained from 1 horse. The latter horse responded to metronidazole treatment followed by procaine penicillin G administration and regained its h...
Clinical pharmacokinetics of metronidazole in horses.
Journal of veterinary pharmacology and therapeutics    December 1, 1988   Volume 11, Issue 4 417-420 doi: 10.1111/j.1365-2885.1988.tb00205.x
Baggot JD, Wilson WD, Hietala S.No abstract available
Equine pleuropneumonia: the importance of anaerobic bacteria and the potential value of metronidazole in treatment.
The Veterinary record    August 1, 1987   Volume 121, Issue 5 109-110 doi: 10.1136/vr.121.5.109
Mair TS, Yeo SP.No abstract available
Pharmacokinetics of metronidazole given to horses by intravenous and oral routes.
American journal of veterinary research    August 1, 1986   Volume 47, Issue 8 1726-1729 
Sweeney RW, Sweeney CR, Soma LR, Woodward CB, Charlton CA.Serum and peritoneal fluid concentrations of metronidazole were determined in 6 healthy adult horses given the drug (25 mg/kg) by IV or oral routes. The disposition of metronidazole in horses given the drug by the IV route conformed to a 2-compartment model with a distribution half-life of 0.16 hours, an elimination half-life of 2.9 hours, and a body clearance of 0.40 +/- 0.05 L/kg/hr. The oral absorption half-life was 0.40 hours, and the bioavailability, 85.0 +/- 18.6%. Peritoneal fluid concentrations were approximately equal to serum concentrations at all times, regardless of the route of ad...
Possible adverse reaction to metronidazole.
The Veterinary record    February 1, 1986   Volume 118, Issue 5 132 doi: 10.1136/vr.118.5.132-a
Owen RR, Jagger DW, Quan-Taylor R.No abstract available