I have to admit, like many colleagues, I believed for many years that giving Flagyl (Metronidazole) for C. diff. colitis should happen only PO. Now I was corrected.
Recently one of the transplant surgeons in the hospital I work in suggested IV Flagyl for a patient with this diagnosis and I objected. She told me that this is a common mistake and comes most probably with the fact that Vancomycin should be given definitely PO for C. diff. colitis.
When I went home, I couldn’t go to bed until I found some papers about this. Well, of course she was right! :)
Searching PubMed for “intravenous[Title] AND metronidazole[Title] AND clostridium[Title] AND difficile[Title]” gave this result. I pulled the articles from the local electronic database of the hospital and… they convinced me.
Even given PO the drug acts by being first absorbed systemically and its concentration in the mucosa of the bowel is what works then again the bacteria. The PO therapy is cheaper but not superior than the IV one.
Again: Flagyl can be given IV for treating Clostridium difficile colitis!
Good to know!
Thanks to the nice surgeon who pointed this for me! :)