title: [Prevention of postoperative anaerobic infections. Economic significance of metronidazole suppositories].
abstract: Metronidazole is widely used in the preventive and curative treatment of post-operative anaerobic infections. As the intravenous form is very expensive, a 1 g suppository has been developed. The pharmacokinetics of metronidazole injection and suppository was studied comparatively in 10 healthy subjects. The serum bioavailability of the rectal form was 80% with a peak serum concentration of 10 mg/l four hours after dosing. From calculated pharmacokinetic values it may be suggested that: (1) in cases of elective surgery treatment could begin with the rectal form alone at the rate of one suppository 12-hourly, starting 48 hours before surgery; (2) in emergency surgery, 0,5g of metronidazole i.v. over 20 minutes and a 1 g suppository should be administered at the time of premedication, treatment being continued with one suppository 12-hourly; (3) in patients at high risk of anaerobic infection, one suppository should be given 8-hourly, starting 24 hours before surgery. The main advantage of the rectal treatment is that it is much cheaper than the intravenous treatment administered during the same period.
mesh_terms: D000328:Adult; D001421:Bacteria, Anaerobic; D001424:Bacterial Infections / Q000517:prevention & control*; D001682:Biological Availability; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D013488:Suppositories
chemical_list: D013488:Suppositories; D008795:Metronidazole
vernacular_title: Prophylaxie des infections postopératoires à germes anaérobies. Intérêt économique des suppositoires de métronidazole.