Metronidazole and Tinidazole

• Surgical or gynaecological sepsis e.g. bacteroides fragilis
• Pseudomembranous colitis
• Trichomonal vaginitis. Treatment with oral metronidazole is effective, and T.vaginalis DNA disappears rapidly after treatment². Metronidazole-resistant trichomoniasis is an infrequent but challenging problem with no universally successful treatment. High-dose tinidazole plus a broad-spectrum antibiotic, i.e. doxycycline or ampicillin, and clotrimazole pessaries, for 7--14 days can be used in this situation. The cure rate has been reported as high as 90%³.
• Helicobacter pylori eradication. H. pylori-infected patients who are allergic to penicillin may be treated with a first-line treatment combining a proton-pump inhibitor, clarithromycin and metronidazole⁴. The effectiveness of these antiinfectives is limited by lack of compliance with treatment regimens, and increasing antibiotic resistance⁵.
• Bacterial vaginosis- gardnerella vaginalis
• Entamoeba histolytica
• Giardia lamblia
• Chronic sinusitis can be managed effectively with a combination of metronidazole and a penicillin⁶
• Established cases of tetanus. Metronidazole, human tetanus immunoglobulin, and active immunization should be initiated on presentation⁷.
• Odour reduction in presence of fungating tumour (topical preparation)
• Acne rosacea (topical preparation).

It is also used as prophylaxis for abdominal ( colon/ rectum) and pelvic ( hysterectomy) surgery.