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Metronidazole, sold under the brand name Flagyl among others, is an antibiotic and antiprotozoal medication. [10] It is used either alone or with other antibiotics to treat pelvic inflammatory disease, endocarditis, and bacterial vaginosis. [10] It is effective for dracunculiasis, giardiasis, trichomoniasis, and amebiasis. [10]
Contraindicated in pregnancy: Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
[19] [58] Other antibiotics related to metronidazole, including tinidazole and the newer secnidazole, are also approved and used to treat BV. [9] [59] [60] When clindamycin is given to pregnant women symptomatic with BV before 22 weeks of gestation the risk of pre-term birth before 37 weeks of gestation is lower. [61]
Cannabis use during pregnancy should be avoided. [80] There is no known safe dose of cannabis while pregnant and use of cannabis may lead to birth defects, pre-term birth, or low birth weight. [80] Tetrahydrocannabinol (THC), an active ingredient in cannabis, can both cross the placenta and accumulates in high concentrations in breast milk. [81]
During pregnancy, paromomycin is the preferred treatment drug because of its poor intestinal absorption, resulting in less exposure to the foetus. [64] Alternatively, metronidazole can be used after the first trimester as there has been wide experience in its use for trichomonas in pregnancy. [20] [65]
Metronidazole, or a related drug such as Tinidazole, Secnidazole or Ornidazole, is used to destroy amoebae that have invaded tissue.; Several drugs are available for treating intestinal infections, the most effective of which has been shown to be Paromomycin (also known as Humatin).
A sensitive serum pregnancy test is typically obtained to rule out ectopic pregnancy. Culdocentesis will differentiate hemoperitoneum (ruptured ectopic pregnancy or hemorrhagic cyst) from pelvic sepsis (salpingitis, ruptured pelvic abscess, or ruptured appendix). [28] Pelvic and vaginal ultrasounds are helpful in the diagnosis of PID.
For people who are symptomatic, it is used after treatment with metronidazole or tinidazole. [2] It is taken by mouth. [1] Diloxanide generally has mild side effects. [3] Side effects may include flatulence, vomiting, and itchiness. [1] During pregnancy it is recommended that it be taken after the first trimester. [1]