Tinidazole in the treatment of surgical and gynaecological infections

Tinidazole was given to 32 patients, 9 men and 23 women, suffering from pelvic cellulitis (15), endometritis (4), various abscesses (5), soft tissue infection with gangrene (7) and diffuse peritonitis (1). Twenty-two patients had mixed aerobic/anaerobic infections, six purely anaerobic and in four no cultures were taken. Tinidazole was administered as a single drug in 23 patients while it was combined with an aminoglycoside in nine others. Fourteen patients were given tinidazole in a single daily dose of 800mg iv, 11 patients 400 mg every 12 h iv, four patients 1000 mg daily rectally and two patients 1000 mg daily orally. When oral feeding was permitted oral therapy was substituted at similar doses. Depending on the severity of the infections the duration of treatment ranged between 3–34 days. In pus cultures Escherichia coli, Peptosireptococcus spp. and Bacteroides fragilis were the predominant isolates. MICs of tinidazole against anaerobes ranged between 0·3–3 mg/l. Complete recovery occurred in 25 patients, while six were improved and I was considered a treatment failure. Simultaneous surgical drainage was performed in five patients. Tinidazole was also shown to be active in vivo against aerobes in the presence of anaerobes since among 14 patients with mixed aerobic/anaerobic infections in whom it was given as a single drug, 13 were cured despite the fact that in all various Enterobacteriaceae were isolated. No appreciable side effects or toxicity were observed. It is concluded that once-daily tinidazole is efficacious in the treatment of anaerobic infections.