Title:Metronidazole Induced Cutaneous Adverse Drug Reaction- A Systematic
Review of Descriptive Studies
Volume: 19
Issue: 3
Author(s): Shifa Taj, Mohammed Zuber*, Vidhyashree Ballagere Hanumanthaiah, Rajesh Venkataraman, Sathish Kumar Puttegowda, Syed Afrid and Sai Kiran
Affiliation:
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, BG
Nagara, Nagamangala, Karnataka, 571448, India
Keywords:
Metronidazole, adverse effect, cutaneous reaction, skin manifestation, case report, systematic review.
Abstract:
Background: A substantial number of research studies on metronidazole-related cutaneous
symptoms have recently been published. Our objective was to identify and evaluate descriptive studies
that described metronidazole-related skin manifestations, therapeutic interventions, and consequences.
Methods: A comprehensive literature search was carried out in the PubMed, Scopus, and grey literature
databases from inception to April 2022 without any constraints, as well as a snowball search in
Google and a search in Google Scholar. Descriptive articles describing metronidazole-related cutaneous
manifestations were considered for the review. Two distinct reviewers carried out the research selection,
data extraction, and quality assessment; any discrepancies were resolved by consensus with
the third reviewer.
Results: About 24 out of 4648 descriptive studies, including 26 patients (20 Female patients and 6
male patients), were included in this review. The included studies comprised a range of ages from 16
to 78 years old. Metronidazole was indicated for the treatment of bacterial vaginosis, trichomoniasis,
sepsis, anti-infection therapy, perforated appendicitis, rosacea, vaginal discharge, dysentery, acne
rosacea, trichomonal vaginitis, lichen planus, liver abscess, facial rosacea, intestinal amoebiasis, and
gingivitis. Fixed drug eruption was the most common skin manifestation which was reported in 7 cases
included in this review. Cutaneous manifestations were ameliorated by cessation of the offending
drug and by apportioning antihistamines, topical steroids, parenteral corticosteroids, emollients, and
topical moisturizers.
Conclusion: Clinicians and healthcare professionals should be cognizant of the potential cutaneous
adverse drug reactions (CADRs) induced by metronidazole to mitigate fatal circumstances. The management
of the CADRs appears to respond effectively with immediate drug discontinuation and supportive
therapy.
