Tinidazole: a review of clinical experience in anaerobic infections.

Abstract

Oral and intravenous tinidazole have been evaluated in an extensive series of clinical trials for the treatment of anaerobic infections and for the prevention of infection after gastrointestinal and gynaecological surgery. In almost all studies simple dosage regimens were used; these were based on the pharmacokinetic properties of tinidazole and its in-vitro activity against almost all clinically relevant anaerobic bacteria. These characteristics permit the use of single pre-operative dpse in surgical prophylaxis and once daily dosage in treatment. Results in the therapy of proven and strongly suspected anaerobic infections in approximately 264 patients are summarized. Patients received tinidazole alone or together with an agent active against aerobes, usually an aminoglycoside. Very good efficacy and an almost complete freedom from significant side effects were observed in patients treated for a wide variety of anaerobic infections. These included septicaemia. upper respiratory infections and sinusitis, anginose infectious mononucleosis, broncho-pulmonary infections, osteomyelitis. pelvic infections. septic abortion, peritonitis and post-operative intra-abdominal sepsis, cellulitis and post-operative wound infection. Chemotherapy was often associated with surgical drainage. Findings with intravenous or oral tinidazole for the prophylaxis of post-operative infections after gastrointestinal and gynaecological surgery are reviewed. Almost all studies involved comparison with another drug regimen, double-blind comparison with placebo or the inclusion of a control group. Although tinidazole alone was used in most trials, an agent active against aerobic bacteria was included in some. A significant reduction in the incidence of infection after colorectal surgery, general abdominal surgery and gynaecological surgery (especially vaginal hysterectomy) was found in all studies. In addition, the prophylactic use of tinidazole was shown in several studies to cause a marked reduction in post-operative antibiotic usage and a shorter hospital stay. Few side effects were reported.