Metronidazole (250 to 500 mg given three to four times daily for 10 to 14 days) is now the first line agent for the treatment of C. difficile infection. It is less expensive and more readily available than vancomycin and is equally effective in terms of response (90%) and relapse (15 to 25%) rates.

Metronidazole can be given either orally or intravenously. Oral metronidazole is well absorbed high in the GI tract but nonetheless achieves bactericidal concentrations in the stool of patients infected by C. difficile. Presumably, metronidazole is secreted through an inflamed intestinal mucosa. Intravenous (IV) metronidazole (500 mg given four times daily) results in stool concentrations comparable to oral dosing and should be used in patients unable to tolerate or absorb oral medications.

Although metronidazole is relatively well tolerated, some patients experience significant side effects including nausea, vomiting, metallic taste, a disulfiram-like reaction to alcohol, and, especially with prolonged use, peripheral neuropathy. It is also contraindicated in children and is considered a class B drug for use in pregnancy and nursing.

Peripheral Neuropathy Natural Treatment Options

Peripheral Neuropathy Natural Treatment Options

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