Abstract
Metronidazole is an important component of combination antimicrobial therapies used in the eradication of Helicobacter pylori, a recognized cause of gastritis and duodenal ulcer. Studies are needed to understand which pharmacokinetic factors determine the success of metronidazole therapy and what role drug monitoring plays. Such studies require a rapid, accurate assay for small volumes of sample, including gastric juice, over a 200-fold range of concentrations. Using an isocratic high-performance liquid chromatography (HPLC) method, with an 8-min run time and protein precipitation of samples, metronidazole could be measured reliably to as low as 0.5 mg/L in 100 microliters samples of serum, gastric juice, or saliva. Standard curves for serum and gastric juice were linear between 0.5 and 50 mg/L. Within-day coefficients of variation (CVs) (n = 5 at six concentrations) ranged from 1.1 to 4.8% over this range and the between-day CV (n = 7 days) was 5.8%. Neither omeprazole nor common gastroenteric and cardiac medications interfered with this assay. A pilot study, done in four healthy volunteers given intravenous metronidazole 500 mg before and after 7 days of omeprazole therapy, found metronidazole to be present in higher concentr...Continue Reading
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