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Prophylaxis of postoperative anaerobic bacterial infections
Adult: 1,000-1,500 mg as a single dose given 30-60 minutes before surgery or 500 mg infused before, during and after surgery. Followed by 500 mg 8 hourly for Max of 48 hours. Continue with oral therapy as soon as possible. Alternatively, 15 mg/kg infused over 30-60 minutes given 1 hour prior to procedure, followed by 7.5 mg/kg infused over 30-60 minutes at 6 and 12 hours after initial dose.
Child: <12 years 20-30 mg/kg as a single dose given 1-2 hours prior to surgery.
Child: <12 years 20-30 mg/kg as a single dose given 1-2 hours prior to surgery.
Intravenous
Anaerobic bacterial infections
Adult: 1,000-1,500 mg once daily as a single dose or 500 mg 8 hourly via infusion at a rate of 5 mL/min over 20-60 minutes usually for about 7 days. Max: 4,000 mg daily. Alternatively, 15 mg/kg over 1 hour, followed by 7.5 mg/kg 6 hourly over 1 hour given 6 hours after loading dose. Max: 4,00 mg daily.
Child: Infants <8 weeks 15 mg/kg once daily or divided into 7.5 mg/kg 12 hourly; >8 weeks to 12 years 20-30 mg/kg as a single dose or divided into 7.5 mg/kg 8 hourly. Treatment duration: Usually, 7 days. Daily dose may be increased to 40 mg/kg based on the severity of the infection.
Child: Infants <8 weeks 15 mg/kg once daily or divided into 7.5 mg/kg 12 hourly; >8 weeks to 12 years 20-30 mg/kg as a single dose or divided into 7.5 mg/kg 8 hourly. Treatment duration: Usually, 7 days. Daily dose may be increased to 40 mg/kg based on the severity of the infection.
Oral
Eradication of Helicobacter pylori associated with peptic ulcer disease
Adult: In combination with another antibacterial and PPI: 400 mg bid. In combination with omeprazole and amoxicillin: 400 mg tid. Treatment duration: 7-14 days. Consult official guidelines before initiating therapy.
Child: In combination with another antibacterial and PPI: 20 mg/kg daily in divided doses for 7-14 days. Max: 500 mg bid.
Child: In combination with another antibacterial and PPI: 20 mg/kg daily in divided doses for 7-14 days. Max: 500 mg bid.
Oral
Anaerobic bacterial infections
Adult: Initially, 800 mg followed by 400 mg 8 hourly usually for about 7 days.
Child: <8 weeks 15 mg/kg once daily or divided into 7.5 mg/kg 12 hourly; >8 weeks to 12 years 20-30 mg/kg as a single dose or divided into 7.5 mg/kg 8 hourly for 7 days. Daily dose may be increased to 40 mg/kg depending on the severity of the infection.
Child: <8 weeks 15 mg/kg once daily or divided into 7.5 mg/kg 12 hourly; >8 weeks to 12 years 20-30 mg/kg as a single dose or divided into 7.5 mg/kg 8 hourly for 7 days. Daily dose may be increased to 40 mg/kg depending on the severity of the infection.
Oral
Bacterial vaginosis
Adult: 400-500 mg bid for 5-7 days. Alternatively, 2,000 mg as a single dose.
Oral
Giardiasis
Adult: 2,000 mg once daily for 3 days, or 400 mg tid for 5 days, or 500 mg bid for 7-10 days.
Child: 1-2 years 500 mg once daily for 3 days; 3-6 years 600-800 mg once daily for 3 days; 7-9 years 1,000 mg once daily for 3 days; ≥10 years Same as adult dose. Alternatively, 15 mg/kg daily in 3 divided doses.
Child: 1-2 years 500 mg once daily for 3 days; 3-6 years 600-800 mg once daily for 3 days; 7-9 years 1,000 mg once daily for 3 days; ≥10 years Same as adult dose. Alternatively, 15 mg/kg daily in 3 divided doses.
Oral
Leg ulcer, Pressure sore
Adult: 400 mg tid for 7 days.
Child: >10 years Same as adult dose.
Child: >10 years Same as adult dose.
Oral
Acute dental infections
Adult: 200 mg tid for 3-7 days.
Child: >10 years Same as adult dose.
Child: >10 years Same as adult dose.
Oral
Trichomoniasis
Adult: 2,000 mg as a single dose or 200 mg 8 hourly for 7 days. Alternatively, 400-500 mg 12 hourly for 5-7 days. Sexual partners should also be treated.
Child: 40 mg/kg as a single dose or 15-30 mg/kg daily in 2-3 divided doses. Max: 2,000 mg/dose. Dosage recommendations may vary among countries and individual products (refer to specific product guidelines).
Child: 40 mg/kg as a single dose or 15-30 mg/kg daily in 2-3 divided doses. Max: 2,000 mg/dose. Dosage recommendations may vary among countries and individual products (refer to specific product guidelines).
Oral
Prophylaxis of postoperative anaerobic bacterial infections
Adult: 400 mg 8 hourly in the 24 hours before surgery followed by IV or rectal dosage post-operatively until oral therapy is possible. Max: 4,000 mg daily.
Child: <12 years 20-30 mg/kg as a single dose given 1-2 hours before surgery.
Child: <12 years 20-30 mg/kg as a single dose given 1-2 hours before surgery.
Oral
Amoebiasis
Adult: 800 mg 8 hourly for 5 days (intestinal infection); 400-800 mg 8 hourly for 5-10 days (extra-intestinal infection). Alternatively, 35-50 mg/kg daily in 3 divided doses for 5-10 days or 500-750 mg 8 hourly for 7-10 days (intestinal or extraintestinal infection). Max: 2,400 mg daily.
Child: 1-3 years 100-200 mg tid; 3-7 years 100-200 mg 4 times daily; 7-10 years 200-400 mg tid. Alternatively, 35-50 mg/kg daily in 3 divided doses. Max: 2,400 mg daily. All doses are given for 5-10 days. >10 years Same as adult dose.
Child: 1-3 years 100-200 mg tid; 3-7 years 100-200 mg 4 times daily; 7-10 years 200-400 mg tid. Alternatively, 35-50 mg/kg daily in 3 divided doses. Max: 2,400 mg daily. All doses are given for 5-10 days. >10 years Same as adult dose.
Oral
Acute ulcerative gingivitis
Adult: 200 mg 8 hourly for 3 days.
Child: 1-2 years 50 mg tid for 3 days; 3-6 years 100 mg bid for 3 days; 7-9 years 100 mg tid for 3 days; ≥10 years Same as adult dose.
Child: 1-2 years 50 mg tid for 3 days; 3-6 years 100 mg bid for 3 days; 7-9 years 100 mg tid for 3 days; ≥10 years Same as adult dose.
Rectal
Anaerobic infections
Adult: As supp: 1,000 mg 8 hourly for 3 days, if needs to continue for more than 3 days, reduce dose to 1 g 12 hourly. Substitute oral therapy as soon as possible.
Child: <1 year 125 mg; 1-4 years 250 mg; 5-9 years 500 mg. All doses are to be given 8 hourly for 3 days, then 12 hourly until oral medication is possible. ≥10 years Same as adult dose.
Child: <1 year 125 mg; 1-4 years 250 mg; 5-9 years 500 mg. All doses are to be given 8 hourly for 3 days, then 12 hourly until oral medication is possible. ≥10 years Same as adult dose.
Rectal
Prophylaxis of postoperative anaerobic bacterial infections
Adult: As supp: 1,000 mg 2 hours before surgery, repeated 8 hourly until oral doses can be given to complete the 7-day treatment course.
Child: As supp: 5-9 years 500 mg; ≥10 years 1,000 mg. All doses are given 2 hours before surgery, then repeated 8 hourly for up to 3 further doses (in high-risk procedures).
Child: As supp: 5-9 years 500 mg; ≥10 years 1,000 mg. All doses are given 2 hours before surgery, then repeated 8 hourly for up to 3 further doses (in high-risk procedures).
Topical/Cutaneous
Rosacea
Adult: For the treatment of inflammatory papules and pustules of rosacea: As 0.75% gel/cream/lotion: Apply thinly onto affected areas bid. Average treatment period: 3-4 months, may be continued for further 3-4 months if necessary, depending on the severity of the infection.
Vaginal
Bacterial vaginosis
Adult: As 0.75% gel: 1 applicator-full (approx 5 g gel containing 37.5 mg metronidazole) once daily at bedtime for 5 days. Alternatively, as 1.3% gel: 1 applicator-full (approx 5 g gel containing 65 mg metronidazole) as a single dose given at bedtime.
