(မိုင်ဂရင်း) ခေါင်းကိုက်-ခေါင်းမူးရောဂါ၊ ခြေလက်တုံအကြောက်ရောဂါ၊ 329. Metronidazole is an antiprotozoal drug also active against most anaerobic gram-negative bacilli (ie, Bacteroides, Prevotella, Fusobacterium) as well as Clostridium species but has minimal activity against many anaerobic gram-positive and microaerophilic organisms. a. Vaginitis caused by Trichomonas vaginalis responds to either a single dose (2 g) or to 250 mg orally three times daily for 7–10 days. Bacterial vaginosis responds to a single 2-g dose or to 500 mg twice daily for 7 days. Metronidazole vaginal cream (0.75%) applied twice daily for 5 days is also effective. b. In anaerobic infections, metronidazole can be given orally or intravenously, 500 mg three times daily (30 mg/kg/d). In contrast to clindamycin or second-generation cephalosporins, metronidazole is active against virtually 100% of B fragilis isolates. c. Metronidazole is equally as efficacious as oral vancomycin for the therapy of C difficile colitis and is the drug of choice for mild to moderate disease. A dosage of 500 mg orally three times daily is recommended. If oral medication cannot be administered, intravenous metronidazole can be tried at the same dose; however, the efficacy associated with this route is unproven and usually less effective than the oral one. Because of the emergence of vancomycin-resistant enterococci as a major pathogen and the role of oral vancomycin in selecting for these resistant organisms, metronidazole should be used as first-line therapy for C difficile disease. While metronidazole and vancomycin are equally effective in the treatment of mild to moderate C difficile disease, oral vancomycin is superior to metronidazole in the treatment of severe disease. d. Preparation of the colon before bowel surgery. e. Therapy of brain abscess, often in combination with penicillin or a third-generation cephalosporin. f. In combination with clarithromycin and omeprazole for therapy of H pylori infections. g. Adverse effects include stomatitis, nausea, and diarrhea. Ingestion of alcohol while taking metronidazole occasionally results in a disulfiram reaction. With prolonged use at high doses, reversible peripheral neuropathy can develop. Metronidazole can decrease the metabolism of warfarin, necessitating dosage adjustment of warfarin. Metronidazole is carcinogenic in certain animal models and mutagenic for certain bacteria, but to date an increased incidence of malignancy has not been confirmed in humans. Metronidazole (Flagyl) (0.5 g) 20 mg/kg; 1500 mg h. Traveler's diarrhea ခရီးသွားဝမ်းလျှောခြင်း၊ Metronidazole 250 mg TDS x 5-7 days i. (ဂိုင်ယာဒီးယား) ပိုးဝင်၍ ဝမ်းပျက်ခြင်း၊ Metronidazole 750 mg TDS x 5-10 days followed by Diiodohydroxyquin 600 mg TDS x 3 weeks j. E histolytica (GE) အစာလမ်း (အူ) ရောင်ခြင်း၊ (အမီးဘား) ဝမ်းကိုက်၊ 400-800 mg TDS x 5-10 days; Children = 100-400 mg TDS k. Amebic liver abscess: (အမီးဘား) အသဲပြည်တည်ခြင်း၊ 500–750 mg TDS x 5–10 days. Children: 35 to 50 mg/kg/24 hours, divided into three doses, orally for 10 days. l. Anaerobic Bacterial Infections လေမကြိုက်သည့်ပိုး အူမကြီးရောင်ခြင်း၊ 500 mg TDS (30 mg/kg/dose) IV; Adult oral dosage is 7.5 mg/kg every six hours x 7 to 10 days; m. (ထရွိုင်ကိုမိုးနပ်စ်) နှင့် (ရိုင်ယာဒီယား) ပိုးများကြောင့် မွေးလမ်းကြောင်း-သားအိမ်ရောင်ခြင်း၊ 250-500 mg TDS; 2 Gm stat or 500 mg BD x 7 days; Metronidazole gel BD x 5 days n. PID တင်ပါးဆုံတွင်းအင်္ဂါများပိုးဝင်ခြင်း၊ 500 mg orally BD x 14 days အခြားဆေးနှင့် တွဲပေးရသည်၊ o. (ဂိုင်ယာဒီးယား)ပိုးဝင်၍ ဝမ်းပျက်ခြင်း၊ 250 mg TDS x 5 days ကျား-မ ဆီးပြွန်ရောင်ခြင်း၊ 500 mg BD x 7 days p. (အမီးဘား) သွားဖုံးရောင်၊ 400 mg TDS x 5-7 days q. ဦးနှောက်ပြည်တည်ခြင်း၊ 7.5 mg/kg orally QID not to exceed 4 grams daily + Penicillin or (Cefixime, Cefdinir, Cefoperazone, Cefotaxime, Cefpodoxime, Ceftazidime, Ceftizoxime, Ceftriaxone) 330. Mexiletine (HCl) 2.857-5.714 mg/kg TDS Oral နှလုံးရောဂါ (Attack, Stroke) ရခြင်း၊ 331. Micafungin (Mycamine) 100 mg 332. Miconazole (ဖန်းဂပ်စ်)ခေါ် မှိုရောဂါလိမ်းဆေး၊ = ointment or cream, 2% (nitrate); Miconazole 2% cream or 100-200 mg suppository OD x 3 days မွေးလမ်းကြောင်းထဲထည့်ရန်၊ မှို Fungus အားကစားသမားခြေထောက်၊ ပွေး Ringworm အတွက်ဆေး။