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DRUG INTOLERANCE and Metronidazole

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DRUG INTOLERANCE Symptoms and Causes

What is diarrhea?

Diarrhea is loose, watery stools (bowel movements). You have diarrhea if you have loose stools three or more times in one day. Acute diarrhea is diarrhea that lasts a short time. It is a common problem. It usually lasts about one or two days, but it may last longer. Then it goes away on its own.

Diarrhea lasting more than a few days may be a sign of a more serious problem. Chronic diarrhea -- diarrhea that lasts at least four weeks -- can be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual, or they may come and go.

Who gets diarrhea?

People of all ages can get diarrhea. On average, adults In the United States have acute diarrhea once a year. Young children have it an average of twice a year.

People who visit developing countries are at risk for traveler's diarrhea. It is caused by consuming contaminated food or water.

What causes diarrhea?

The most common causes of diarrhea include

  • Bacteria from contaminated food or water
  • Viruses such as the flu, norovirus, or rotavirus . Rotavirus is the most common cause of acute diarrhea in children.
  • Parasites, which are tiny organisms found in contaminated food or water
  • Medicines such as antibiotics, cancer drugs, and antacids that contain magnesium
  • Food intolerances and sensitivities, which are problems digesting certain ingredients or foods. An example is lactose intolerance.
  • Diseases that affect the stomach, small intestine, or colon, such as Crohn's disease
  • Problems with how the colon functions, such as irritable bowel syndrome

Some people also get diarrhea after stomach surgery, because sometimes the surgeries can cause food to move through your digestive system more quickly.

Sometimes no cause can be found. If your diarrhea goes away within a few days, finding the cause is usually not necessary.

What other symptoms might I have with diarrhea?

Other possible symptoms of diarrhea include

  • Cramps or pain in the abdomen
  • An urgent need to use the bathroom
  • Loss of bowel control

If a virus or bacteria is the cause of your diarrhea, you may also have a fever, chills, and bloody stools.

Diarrhea can cause dehydration, which means that your body does not have enough fluid to work properly. Dehydration can be serious, especially for children, older adults, and people with weakened immune systems.

When should I see a doctor for diarrhea?

Although it is usually not harmful, diarrhea can become dangerous or signal a more serious problem. Contact your health care provider if you have

  • Signs of dehydration
  • Diarrhea for more than 2 days, if you are an adult. For children, contact the provider if it lasts more than 24 hours.
  • Severe pain in your abdomen or rectum (for adults)
  • A fever of 102 degrees or higher
  • Stools containing blood or pus
  • Stools that are black and tarry

If children have diarrhea, parents or caregivers should not hesitate to call a health care provider. Diarrhea can be especially dangerous in newborns and infants.

How is the cause of diarrhea diagnosed?

To find the cause of diarrhea, your health care provider may

  • Do a physical exam
  • Ask about any medicines you are taking
  • Test your stool or blood to look for bacteria, parasites, or other signs of disease or infection
  • Ask you to stop eating certain foods to see whether your diarrhea goes away

If you have chronic diarrhea, your health care provider may perform other tests to look for signs of disease.

What are the treatments for diarrhea?

Diarrhea is treated by replacing lost fluids and electrolytes to prevent dehydration. Depending on the cause of the problem, you may need medicines to stop the diarrhea or treat an infection.

Adults with diarrhea should drink water, fruit juices, sports drinks, sodas without caffeine, and salty broths. As your symptoms improve, you can eat soft, bland food.

Children with diarrhea should be given oral rehydration solutions to replace lost fluids and electrolytes.

Can diarrhea be prevented?

Two types of diarrhea can be prevented - rotavirus diarrhea and traveler's diarrhea. There are vaccines for rotavirus. They are given to babies in two or three doses.

You can help prevent traveler's diarrhea by being careful about what you eat and drink when you are in developing countries:

  • Use only bottled or purified water for drinking, making ice cubes, and brushing your teeth
  • If you do use tap water, boil it or use iodine tablets
  • Make sure that the cooked food you eat is fully cooked and served hot
  • Avoid unwashed or unpeeled raw fruits and vegetables

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

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DRUG INTOLERANCE Clinical Trials and Studies

Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. People participate in clinical trials for a variety of reasons. Healthy volunteers say they participate to help others and to contribute to moving science forward. Participants with an illness or disease also participate to help others, but also to possibly receive the newest treatment and to have the additional care and attention from the clinical trial staff.
Rank Status Study
1 Recruiting Comparison Between Oral Clindamycin Vs Metronidazole for the Treatment of Abnormal Vaginal Flora in High Risk Pregnancies
Conditions: Abnormal Vaginal Flora;   Clindamycin Vs Metronidazole;   High Risk Pregnancies for Preterm Labor
Interventions: Drug: Clindamycin;   Drug: Metronidazole
Outcome Measures: To compare the efficacy between oral Clindamycin Vs Metronidazole in the eradication of abnormal vaginal flora;   The prevalence of adverse effects;   The prevalence of late abortions and preterm deliveries;   Assessing the correlation between Nugent score , physical examination and Ph indicators
2 Recruiting Azithromycin Based Therapy for Induction of Remission in Active Pediatric Crohn's Disease
Condition: Crohn's Disease
Interventions: Drug: Azithromycin + Metronidazole;   Drug: Metronidazole
Outcome Measures: Response rate at 8 weeks defined as a drop in PCDAI (Pediatric Crohn's Disease Activity Index ) of at least 12.5 points (or remission without steroids, intention to treat principle);   Normalization of CRP ( CRP ≤0.5 mg/dL).;   Fecal calprotectin at 8 weeks .
3 Not yet recruiting Study to Determine the Equivalence of Three Products Containing Metronidazole Benzoate.
Condition: Bacterial Infections
Interventions: Drug: Metronidazole benzoate;   Drug: Flagyl 125 mg/5 ml oral suspension;   Drug: Flagyl 400 mg Tablets
Outcome Measures: Plasma concentration time profiles under the curve (AUC);   Maximum concentration (Cmax);   Time to maximum concentration (Tmax);   Elimination rate constant (Kel);   Terminal half life (t1/2);   Number of participants with Adverse Events
4 Recruiting BASIC (Boric Acid, Alternate Solution for Intravaginal Colonization) Study
Condition: Bacterial Vaginosis
Interventions: Drug: Gelatin;   Drug: Boric acid;   Drug: Metronidazole
Outcome Measures: Effectiveness of treatment of intravaginal boric acid and Metronidazole at 1 week and 30 days post-treatment will be measured as absence of symptoms or negative vaginal swab (Nugent score less than 7) if symptoms are present for BV.;   If during the 10 days of treatment of intravaginal boric acid and Metronidazole the patient discontinues the treatment because of side effects or complained of intolerable side effects this will be considered a treatment failure for safety.
5 Unknown  Increased Re-eradication Rate of Helicobacter Pylori by Adding N-acetylcystein or Metronidazole to the Triple Therapy
Condition: Bacterial Infection Due to Helicobacter Pylori (H. Pylori)
Interventions: Drug: 10RAC+acetylcystein;   Drug: 10RAC+Metronidazole
Outcome Measures: Re-eradication rate;   Influence of Participant's CYP2C19 genotype on re-eradication rate
6 Unknown  Moxifloxacin Plus Metronidazole Versus Piperacillin/Tazobactam for the Treatment of Patients With Intra-abdominal Abscesses
Condition: Abscess, Intra-Abdominal
Intervention: Drug: Moxifloxacin/Metronidazole or Piperacillin/Tazobactam
Outcome Measures: Clinical success / failure rate at the Test-of-Cure visit;   Clinical + Bacteriological response at End-of-Treatment-visit;   Time to discharge from hospital;   Course of disease on the basis of clinical and laboratory parameters;   safety and tolerability of the study medication;   cost effectiveness of treatment regimes
7 Recruiting Compare Ceftazidime-Avibactam + Metronidazole Versus Meropenem for Hospitalized Adults With Complicated Intra-Abdominal Infections
Condition: Complicated Intra-Abdominal Infection
Interventions: Drug: CAZ-AVI;   Drug: Metronidazole;   Drug: Meropenem
Outcome Measures: Clinical Cure as Measured by proportion of patients meeting cure criteria in the microbiological modified Intent-To-Treat analysis set.;   The proportion of patients with clinical cure in the microbiologically evaluable and extended microbiologically evaluable analysis set;   The proportion of patients with clinical cure in the microbiological modified intent-to-treat, microbiologically evaluable, and extended microbiologically evaluable analysis sets;   The proportion of patients with clinical cure in the clinically evaluable analysis set.;   The proportion of patients with a favorable per-patient microbiological response in the microbiological modified intent to treat, microbiologically evaluable, and extended microbiologically evaluable analysis sets;   The proportion of favorable per-pathogen microbiological response in the microbiological modified intent to treat, microbiologically evaluable, and extended microbiologically evaluable analysis sets;   The favorable per-pathogen microbiologic response by minimum inhibitory concentration (MIC) categories in the microbiological modified intent to treat, microbiologically evaluable, and extended microbiologically evaluable analysis sets;   Favorable per-patient clinical response & microbiological response for patients infected with ceftazidime-resistant pathogens in microbiological modified intent to treat, microbiologically evaluable & extended microbiologically evaluable analysis sets;   Proportion of patients with favorable per-pathogen microbiological response for patients infected with ceftazidime-resistant pathogens in microbiological modified ITT, microbiologically evaluable and extended microbiologically evaluable analysis sets;   The time to first defervescence in the clinically evaluable, microbiologically evaluable, and extended microbiologically evaluable analysis sets for patients who have fever at study entry;   The safety and tolerability by incidence and severity of adverse events and serious adverse events, vital signs, clinical laboratory tests, ECGs and physical exams.;   Pharmacokinetics: maximum concentration (Cmax), minimum concentration, area under the plasma concentration time curve at steady state, and terminal half-life
8 Recruiting Role of N-Acetylcysteine in Treatment of Bacterial Vaginosis
Condition: Bacterial Vaginosis
Interventions: Drug: N-Acetyl cysteine;   Drug: Metronidazole + N-Acetyl cysteine;   Drug: Metronidazole
Outcome Measures: recovery of BV;   prevention of recurrence
9 Recruiting Compare Ceftazidime-Avibactam + Metronidazole vs Meropenem for Hospitalized Adults With Complicated Intra-Abd Infections
Condition: Complicated Intra-abdominal Infection
Interventions: Drug: Ceftazidime-avibactam;   Drug: Metronidazole;   Drug: Meropenem
Outcome Measures: The proportion of patients with clinical cure in the clinically evaluable analysis set;   The proportion of patients with clinical cure in the microbiologically evaluable, extended microbiologically evaluable and microbiological modified intent-to-treat analysis sets;   The proportion of patients with a favorable per-patient microbiological response in the microbiological modified intent to treat, microbiologically evaluable and extended microbiologically evaluable analysis sets;   The proportion of favorable per-pathogen microbiological response in the microbiological modified intent to treat, microbiologically evaluable and extended microbiologically evaluable analysis sets;   The favorable per-pathogen microbiologic response by minimum inhibitory concentration categories in the microbiological modified intent to treat, microbiologically evaluable and extended microbiologically evaluable analysis sets;   Favorable clinical response and favorable per-patient microbiological response for patients infected with ceftazidime-resistant pathogens in the microbiological modified intent to treat and (extended) microbiologically evaluable analysis sets;   The proportion of patients with a favorable per-pathogen microbiological response for patients infected with ceftazidime-resistant pathogens in the microbiological modified intent to treat and (extended) microbiologically evaluable analysis sets;   The time to first defervescence in the clinically evaluable, microbiologically evaluable and extended microbiologically evaluable analysis sets for patients who have fever at study entry;   Safety and tolerability by incidence and severity of adverse events and serious adverse events, exposure, mortality, reasons for discontinuations of study therapy, vital signs, laboratory tests, electrocardiogram parameters and physical exams
10 Unknown  Effects of the Variation in the Time of Systemic Administration of Metronidazole and Amoxicillin Associated to the Non-surgical Therapy of Chronic Periodontitis.
Conditions: Chronic Periodontitis;   Clinical and Microbiological Effects
Intervention: Drug: Administration of Metronidazole plus Amoxicillin
Outcome Measures: - Mean change in clinical attachment level (CAL);   - Mean change in probing pocket depths (PD)
11 Recruiting Impact of Oral Antibiotic Treatment on C. Difficile
Conditions: C. Difficile;   Diarrhea;   Enterocolitis
Interventions: Drug: Fidaxomicin;   Drug: Metronidazole;   Drug: Vancomycin
Outcome Measures: Change in variation of the profile of C. difficile isolated from specific body sites of a patient with microbiology-proven CDAD;   Change in variation in the profile of C. difficile isolated from targeted surfaces in a hospital;   Extent and quantity of C. difficile shedding, colonization and environmental contamination in patients who received oral fidaxomicin vs. oral Metronidazole or vancomycin;   Duration of diarrhea that were positive for CDAD
12 Recruiting The Use of Erythritol Powder and Metronidazole Gel for the Non-surgical Treatment of Periodontitis
Condition: Periodontal Pocket
Interventions: Drug: Metronidazole gel;   Procedure: ultrasonics;   Procedure: erythritol;   Drug: placebo
Outcome Measures: Probing pocket Depth change;   Bleeding on Probing change;   Clinical Attachment level change
13 Unknown  Inflammation and Treatment of Bacterial Vaginosis Near Term
Condition: Bacterial Vaginosis
Interventions: Drug: Metronidazole;   Drug: Placebo
Outcome Measure: Levels of Interleukins 1 and 6 as well as Tumor Necrosis Factor Alpha
14 Recruiting Comparison of the Eradications Rates of Sequential Therapy Versus Concomitant Therapy
Condition: Helicobacter Pylori Infection
Interventions: Drug: pantoprazole, amoxicillin, clarithromycin, Metronidazole;   Drug: pantoprazole, amoxicillin, clarithromycin, metronidzole
Outcome Measure: Comparison of the eradications rates of sequential therapy versus concomitant therapy of treatment of Helicobacter pylori infection in Korea.
15 Unknown  The Impact of Obesity on Nonsurgical Periodontal Therapy
Conditions: Periodontitis;   Periodontal Diseases;   Obesity
Interventions: Drug: Metronidazole;   Drug: Placebo;   Procedure: Scaling and root planning
Outcome Measures: Probing depth;   Attachment level
16 Recruiting Antibiotic Safety (SCAMP)
Condition: Complicated Intra Abdominal Infections
Interventions: Drug: ampicillin and Metronidazole and gentamicin;   Drug: ampicillin and gentamicin and clindamycin;   Drug: gentamicin and Piperacillin- tazobactam;   Drug: standard of care antibiotics and Metronidazole
Outcome Measures: Death;   Number of participants with therapeutic success at Day 30 and Day 90
17 Recruiting Study of Dexamethasone-Allantoin-Metronidazole (DAM) Solution in the Treatment of Post-Operative Ileus (POI)
Condition: Postoperative Ileus
Interventions: Drug: DAM;   Drug: Normal Saline
Outcome Measures: Time to achieve recovery of both upper and lower GI function as measured by a composite endpoint of time to the first bowel movement and time to tolerate first solid food. This endpoint is referred to as GI2.;   Time to ready for discharge;   Time to the first flatus;   Comparison between the 2 groups of analgesics (morphine) dose;   peritoneal exudate volume of 72 hours after operation;   C reactive protein changes from baseline
18 Recruiting Concomitant Therapy of H. Pylori
Condition: Gastritis, Gastric Ulcer, and Duodenal Ulcer
Intervention: Drug: amoxicillin, clarithromycin, Metronidazole, rabeprazole
Outcome Measure: Evaluation of the efficacy of concomitant therapy for eradication of Helicobacter pylori
19 Recruiting Efficacy Study of Preconception Treatment of an Asymptomatic Bacterial Infection in an Infertility Population
Conditions: Vaginosis, Bacterial;   Infertility;   Miscarriage
Interventions: Drug: Metronidazole;   Drug: Placebo
Outcome Measures: Biochemical Pregnancy Rate (Positive Pregnancy Test);   Pregnancy Rate (Pregnancy Visible on Ultrasound);   Miscarriage Rate (Loss of a Clinically Recognized Pregnancy);   Infectious Morbidity (i.e. Chorioamnionitis, Neonatal Sepsis)
20 Recruiting Multi-center Clinical Study of Early Antibios of Severe Acute Pancreatitis
Condition: Pancreatitis,Acute Necrotizing
Interventions: Drug: cefoperazone + Metronidazole;   Procedure: oral care by chlorhexidine gluconate;   Procedure: enteral nutrition;   Drug: Somatostatin;   Drug: Meropenem
Outcome Measures: pancreatic or peripancreatic infection;   cost of management of SAP;   Microbiology resistance