title: The effect of metronidazole on TPN-associated liver dysfunction in neonates.
abstract: The effect of metronidazole (MNZ) on hepatic dysfunction associated with total parenteral nutrition (TPN) in neonates was investigated. Neonates receiving TPN for more than 2 weeks were divided into three groups. In group 1, TPN was given alone, in group 2, 25 mg/kg/d of MNZ was administered intravenously for the first 2 weeks of TPN, and in group 3, 50 mg/kg/d of MNZ was given for the first 3 weeks of TPN. Several parameters of liver function tests (LFTs) during the first 4 weeks of TPN were compared among these three groups. There was no significant difference of these parameters between group 1 and group 2. Although there was no significant difference of alkaline phosphatase, gamma-glutamyl transpeptidase, direct bilirubin, and total bile acid between groups 1 and 3, transaminase (glutamic oxaloacetic, glutamic pyruvic) of group 3 remained significantly lower than those of group 1. In conclusion, the administration of MNZ 50 mg/kg/d for 3 weeks, at least, prevented the elevation of transaminase during TPN in neonates, suggesting the possible involvement of intestinal anaerobic flora in the pathogenesis of TPN-associated liver dysfunction.
authors.affiliation: Department of Pediatric Surgery, Osaka University Medical School, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Kubota
authors.forename: A
authors.initials: A
authors.lastname: Okada
authors.forename: K
authors.initials: K
authors.lastname: Imura
authors.forename: H
authors.initials: H
authors.lastname: Kawahara
authors.forename: R
authors.initials: R
authors.lastname: Nezu
authors.forename: S
authors.initials: S
authors.lastname: Kamata
authors.forename: Y
authors.initials: Y
authors.lastname: Takagi
mesh_terms: D002780:Cholestasis, Intrahepatic / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008795:Metronidazole / Q000494:pharmacology / Q000627:therapeutic use*; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D000637:Transaminases / Q000378:metabolism
chemical_list: D008795:Metronidazole; D000637:Transaminases