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Metronidazole-associated pancreatitis.
M E Sura1, K A Heinrich, M Suseno
1Evanston Northwestern Healthcare-Evanston Hospital, IL 60201, USA. msuraENH@hotmail.com
The Annals of Pharmacotherapy
|October 31, 2000
Summary
This case report highlights acute pancreatitis as a potential adverse effect of metronidazole, an antibiotic used for aspiration pneumonia. Discontinuation of metronidazole led to rapid symptom and enzyme level improvement, suggesting a drug-induced cause.
Area of Science:
- Gastroenterology
- Pharmacology
- Critical Care Medicine
Background:
- Metronidazole is an antibiotic commonly prescribed for anaerobic bacterial infections.
- Aspiration pneumonia is a serious complication, particularly in post-surgical patients.
- Drug-induced pancreatitis is an uncommon but significant clinical concern.
Observation:
- A 61-year-old female developed acute pancreatitis symptoms, including severe abdominal pain, after initiating metronidazole for suspected aspiration pneumonia.
- Elevated serum amylase and lipase levels were observed four days into metronidazole treatment.
- Symptoms and pancreatic enzyme levels resolved within one week of discontinuing metronidazole.
Findings:
- This case suggests a probable association between metronidazole use and the development of acute pancreatitis.
- The mechanism may involve oxidative stress from metronidazole's redox cycling, potentially damaging pancreatic beta-cells.
- Rechallenge with metronidazole should be avoided if suspected as the causative agent.
Implications:
- Clinicians should consider metronidazole as a potential cause of acute pancreatitis in patients presenting with compatible symptoms.
- Early recognition and discontinuation of the offending agent are crucial for patient recovery.
- Further research is needed to elucidate the exact mechanisms and long-term sequelae of metronidazole-induced pancreatitis.