Metronidazole

Metronidazole is an imidazole derivative substituted at C-1, C-2, and C-5 with 2-hydroxyethyl, nitro, and methyl groups, respectively. It exhibits activity against anaerobic bacteria and protozoa and has a radiosensitizing effect on hypoxic tumor cells. It is available orally as tablets or as the benzoate in suspension, and its hydrochloride salt is used in intravenous infusions. As a prodrug, it is selectively active against anaerobic bacteria due to their ability to reduce the nitro group to nitroso intermediates, which covalently bind to DNA, disrupting its structure, causing strand breaks, and inhibiting nucleic acid synthesis, leading to bacterial cell death. It functions as an antitrichomonal, antiparasitic, antiamoebic, antibacterial, antimicrobial, and radiosensitizing agent. It is classified as an imidazole, C-nitro compound, primary alcohol, and conjugate base of metronidazole(1+).