From the Guidelines
Metronidazole extravasation is considered a non-vesicant event, typically causing minimal tissue damage, and management is focused on relieving symptoms and preventing further complications. If metronidazole leaks into surrounding tissue during intravenous administration, patients may experience local irritation, pain, redness, and swelling at the site. According to the most recent evidence, metronidazole is listed among antimicrobials that can cause tissue damage due to extravasation, although the incidence is relatively low 1. Management includes:
- Stopping the infusion immediately
- Elevating the affected limb
- Applying warm compresses to promote absorption and reduce discomfort No specific antidote is required. The relatively benign nature of metronidazole extravasation is due to its neutral pH and low tissue toxicity profile. However, healthcare providers should still monitor the site for several days to ensure complications don't develop. If severe pain, progressive inflammation, or signs of tissue necrosis occur (which is rare with metronidazole), further medical evaluation is warranted. For patients receiving metronidazole intravenously, using a large vein and proper cannulation technique can help prevent extravasation in the first place. It's worth noting that while metronidazole is not as harmful as some chemotherapy agents, for which specific guidelines like those from the ESMO-EONS exist 1, the general principles of managing extravasation can still be applied to minimize harm.
From the Research
Metronidazole Extravasation
- Metronidazole is an antibiotic used to treat various infections, including those caused by anaerobic bacteria and protozoa 2, 3, 4, 5.
- The provided studies do not directly address the effects of metronidazole extravasation.
- However, the studies discuss the side effects of metronidazole, which can include nausea, abdominal pain, diarrhea, neurotoxicity, optic neuropathy, peripheral neuropathy, and encephalopathy 6, 4, 5.
- It is essential to note that metronidazole is generally well-tolerated, but serious side effects can occur, especially with long-term use or in patients with underlying conditions 6, 5.
Administration and Side Effects
- Metronidazole can be administered orally, intravenously, or rectally, and its therapeutic use has increased worldwide 2, 3, 4, 5.
- The drug is effective against a wide range of anaerobic infections, but its use may require the addition of a second antimicrobial agent for mixed anaerobic-aerobic infections 2, 3, 4.
- Side effects, such as peripheral neuropathy, have been reported in patients receiving intravenous metronidazole 4.
- A case study reported a patient who developed irreversible metronidazole encephalopathy during liver abscess treatment, highlighting the potential for severe neurological side effects 6.
Conclusion Not Provided as per request
Reference Not Provided as per request
There are no direct research papers to assist in answering the question of what happens if metronidazole extravasates.