Nitroimidazole antiprotozoal drug (See CH 52), that also has potent antibacterial activity against anaerobes, including bacteroides and Clostridium. Penetrates well into CSF and brain.

Altered taste

Inhibits alcohol metabolism

Avoid alcohol when taking it

Rx: anaerobic (bacteroides &

Clostridium), mixed intra-abdominal infections, vaginitis (trichomonas, vaginosis), C difficile colitis, brain abscess

Oral agents that exerts antibacterial activity in urine but has little or no systemic antibacterial effect.  Usefulness limited to lower urinary tract infections; chronic UTIs.

Anorexia, nausea/vomiting,

neuropathies & hemolytic anemia,

hypersensitivity (nausea,  pulmonary infiltration/fibrosis)

CI: significant renal insufficiency

Bacteriostatic and bactericidal activity against gram(+/-)

Uncomplicated UTIs and long term prophylaxis for recurrent UTIs

Basic peptide active against gram(-) bacteria.  Act like cationic detergents.  Attach to and disrupt bacterial cell membranes.  Also bind and inactivate endotoxin.

Limited to topical use

Significant toxicity systemically

Gram negative bacteria

Peptide antibiotic

Allergic contact dermatitis, systemic toxicity (so can only be used topically)

Rx: gram(+) - streptococci,

pneumococci, staphylococci;

anaerobic cocci, neisseriae; tetanus bacilli; diphtheria bacilli