Metronidazole use in malodorous skin lesions.

Malodorous skin lesions (primarily fungating tumors and decubitus ulcers) can be extremely resistant to efforts to control their odors. The offending bacteria appear to be anaerobes, specifically the Bacteroides species. Topical metronidazole has shown promise for odor control without the cost or side effects of a systemic drug. In various anecdotal reports, lesions in patients treated with topical metronidazole were virtually free of odor within 24 hours, and in some cases, slight improvements in wound appearance and pain also were noted. The encouraging results of these initial experiences with topical metronidazole warrant further study for its efficacy in reducing skin lesion odor.