Penetration of metronidazole and tinidazole into the aqueous humor in man

Pharmacokinetics of metronidazole in horses after intravenous, rectal and oral administration

Metronidazole pharmacokinetics in horses was studied after intravenous (i.v.), rectal (p.r.) and oral (p.o.) administration at 20 mg/kg using a triple crossover study design. Metronidazole mean+/-SD half-life was 196+/-39, 212+/-30 and 240+/-65 min after i.v., p.r. and p.o. administration, respectively. The metronidazole clearance was 2.8 (mL/min/kg) and the volume of distribution at steady state was 0.68 L/kg. The pharmacokinetic parameters calculated for metronidazole after administration of the drug by the various routes showed that bioavailability (74+/-18 vs. 30+/-9%) and maximum serum concentration (22+/-8 vs. 9+/-2 microg /mL) were significantly higher after p.o. administration compared with p.r. administration. There were no significant differences in mean absorption time (45+/-69 vs. 66+/-18 min) and the time to reach maximum serum concentration (65+/-36 vs. 58+/-18 min). The results indicated that p.r. administration of metronidazole to horses, although inferior to p.o. administration in terms of bioavailability, provides an alternative route of administration when p.o. administration cannot be used.

Pharmacokinetics of tinidazole in the horse

Serum tinidazole concentrations were monitored in five clinically healthy adult horses after intravenous (i.v.) and oral administration of the drug (15 mg/kg and 25 mg/kg, respectively). After i.v. administration, the mean residence time was 7.0 h, the elimination half-life 5.2 h and the body clearance rate 1.6 ml/min/kg. The distribution volume was found to be 660 ml/kg. After oral administration, the mean residence time was 8.5 h, the absorption half-life 1.1 h and the bioavailability essentially 100%. In view of the in-vitro sensitivities of various anaerobic bacteria, a dosage of 10-15 mg/kg of tinidazole, orally, at 12-h intervals, can be recommended for the treatment of anaerobic infections in horses.

Metronidazole

Metronidazole was introduced to the market in 1959 as the only effective therapy for Trichomonas vaginalis. A nitroimidazole derivative, its success in the therapy of parasitic infections, including Entamoeba histolytica and Giardia lamblia, has been well documented. Metronidazole's activity against anaerobic bacteria was first described in 1962 by Shinn, and by Davies and associates in 1964. In both reports, metronidazole effectively treated patients with Vincent's angina (necrotizing ulcerative gingivitis). Metronidazole's excellent activity against anaerobes has been substantiated by numerous articles. It has the best bactericidal activity of all drugs active against anaerobic bacteria.

Concentrations of metronidazole and tinidazole in male genital tissues

The steady-state concentrations of metronidazole and tinidazole in male genital tissues were analyzed in patients subjected to elective gonadal surgery. The nitroimidazoles were administered orally at 500 mg every 8 h, beginning 5 days before the operation. Eight hours after the last dose, the concentrations of tinidazole were 24.1 +/- 2.5 micrograms (mean +/- standard error of the mean)/g of prostatic tissue, 29.1 +/- 2.9 micrograms/g of vas deferens, 22.1 +/- 2.1 micrograms/g of epididymis, and 18.6 +/- 2.3 micrograms/g of testis. The corresponding values of metronidazole were 14.3 +/- 1.8 micrograms/g, 15.9 +/- 1.2 micrograms/g, 14.0 +/- 1.2 micrograms/g, and 12.5 +/- 1.7 micrograms/g, respectively.

Placental transfer of metronidazole and tinidazole in early human pregnancy after a single infusion

Concentrations of metronidazole and tinidazole were analysed in mother's serum, placental tissue and foetal tissue after a single intravenous infusion of 500 mg of either drug in 21 patients who underwent a first trimester legal abortion. At the time of the evacuation (60 min from the start of the infusion) the concentrations of metronidazole and tinidazole in serum were 13.6 +/- 0.6 micrograms/ml and 13.2 +/- 0.4 micrograms/ml, respectively. In foetal tissue the concentrations of metronidazole and tinidazole reached 66% and 58%, and in placental tissue 26% and 37%, of the respective serum values.

Concentrations of metronidazole and tinidazole in female reproductive organs after a single intravenous infusion and after repeated oral administration

Concentrations of metronidazole and tinidazole in serum and gynecological organs were analyzed after a single 500 mg intravenous infusion and after three days of treatment with 400 mg t.i.d. of metronidazole or 500 mg b.i.d. of tinidazole. The studies were performed in 67 patients subjected to hysterectomy and/or oophorectomy because of myomatosis uteri, carcinoma uteri or endometriosis. At the time of organ removal (about 30 min after infusion), metronidazole and tinidazole levels in serum were 14.5 +/- 0.45 mg/l and 12.3 +/- 0.38 mg/l, respectively. Concentrations of both drugs in the uterus and Fallopian tube were about the same as the simultaneous serum levels and concentrations in the ovaries about 55% thereof. At steady-state, the concentrations of tinidazole in serum (23.5 +/- 1.0 mg/l) were remarkably higher than those of metronidazole (13.5 +/- 0.84 mg/l) about three hours after the last oral dose. Drug concentrations in organs of the female reproductive tract were 70 to 100% those of the simultaneous serum levels.