Metronidazole in prevention of cholestasis associated with total parenteral nutrition

The effect of metronidazole on liver function tests was studied in patients given total parenteral nutrition (TPN) for an acute attack of Crohn's disease. In those receiving TPN and metronidazole, serum activities of alkaline phosphatase and gamma-glutamyl-transferase decreased or remained normal after 30 days of TPN. In contrast, serum activities of these enzymes increased significantly after 30 days of TPN alone. These results suggest that intrahepatic cholestasis associated with TPN may be related to intestinal overgrowth of anaerobic bacteria.