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Related Experiment Video

Updated: Dec 23, 2025

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Metronidazole-associated Neurologic Events: A Nested Case-control Study.

Nick Daneman1,2,3,4, Yi Cheng1, Tara Gomes1,5

  • 1ICES, Toronto, Ontario, Canada.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|April 19, 2020
PubMed
Summary

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Metronidazole use is linked to a higher risk of nervous system issues compared to clindamycin. Patients and doctors should monitor for these rare but serious side effects.

Area of Science:

  • Neurology
  • Pharmacology
  • Clinical Medicine

Background:

  • Case reports suggest metronidazole may cause nervous system toxicity.
  • Large-scale studies investigating this association are lacking.

Purpose of the Study:

  • To investigate the association between metronidazole use and nervous system adverse events.
  • To compare the risk of neurologic events between metronidazole and clindamycin users.

Main Methods:

  • Population-based nested case-control study in Ontario, Canada (2003-2017).
  • Included adults aged 66+ who received metronidazole or clindamycin.
  • Cases had hospital admission for neurologic events; controls were matched.

Main Results:

Keywords:
cerebellar syndromeencephalopathymetronidazoleperipheral neuropathypharmacoepidemiology

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  • 1212 cases and 12,098 controls identified.
  • Metronidazole use was associated with increased odds of neurologic events (aOR 1.43).
  • Association observed for both central and peripheral nervous system events.
  • Conclusions:

    • Metronidazole is associated with an increased risk of peripheral and central nervous system events compared to clindamycin.
    • Clinicians and patients should be aware of these potential adverse events.