Bolton R P, Culshaw M A
Gut. 1986 Oct;27(10):1169-72. doi: 10.1136/gut.27.10.1169.
Faecal metronidazole and hydroxymetronidazole concentrations measured by high pressure liquid chromatography are reported during 10 episodes of Clostridium difficile colitis in nine patients. Bactericidal faecal concentrations were present in all patients with acute disease receiving oral or intravenous metronidazole, and all responded to therapy. Metronidazole and hydroxymetronidazole concentrations fell as the diarrhoea improved and neither substance was detectable in the faeces of five patients after recovery. This demonstration of intracolonic therapeutic concentrations of metronidazole supports the clinical experience of oral metronidazole being effective in the treatment of antibiotic associated diarrhoea caused by C difficile and also suggests a potential role for intravenous metronidazole in this disease.
本文报道了通过高压液相色谱法测定的9例患者10次艰难梭菌结肠炎发作期间粪便中甲硝唑和羟甲硝唑的浓度。所有接受口服或静脉注射甲硝唑治疗的急性病患者粪便中均存在杀菌浓度，且所有患者对治疗均有反应。随着腹泻改善，甲硝唑和羟甲硝唑浓度下降，5例患者康复后粪便中均未检测到这两种物质。结肠内甲硝唑治疗浓度的这一证明支持了口服甲硝唑有效治疗艰难梭菌引起的抗生素相关性腹泻的临床经验，也提示了静脉注射甲硝唑在该病中的潜在作用。
