From the FDA Drug Label
Anaerobes: Serious respiratory tract infections such as empyema, anaerobic pneumonitis, and lung abscess; serious skin and soft tissue infections; septicemia; intra- abdominal infections such as peritonitis and intra-abdominal abscess Anaerobic Bacterial Infections In the treatment of most serious anaerobic infections, the intravenous form of metronidazole is usually administered initially.
Anaerobic support refers to the treatment of infections caused by anaerobic bacteria, which are bacteria that thrive in environments without oxygen. This includes infections such as:
- Serious respiratory tract infections
- Skin and soft tissue infections
- Septicemia
- Intra-abdominal infections These infections are typically treated with antibiotics such as clindamycin or metronidazole 1, 2.
From the Research
Anaerobic support refers to the treatment of anaerobic infections, and the most effective approach is to use antimicrobials such as metronidazole, carbapenems, chloramphenicol, and combinations of a penicillin and a beta-lactamase inhibitor, as recommended by the most recent study 3. The treatment of anaerobic infections is complicated by the slow growth of these organisms, their polymicrobial nature, and their growing resistance to antimicrobials.
- The most effective antimicrobials against anaerobes are:
- metronidazole
- the carbapenems (imipenem, meropenem, doripenem, ertapenem)
- chloramphenicol
- the combinations of a penicillin and a beta-lactamase inhibitors (ampicillin or ticarcillin plus clavulanate, amoxicillin plus sulbactam, piperacillin plus tazobactam)
- tigecycline
- cefoxitin
- clindamycin, as reported in 3. Antimicrobial therapy is often the only therapy required, or it is an important adjunct to a surgical approach, such as drainage and debridement, as noted in 4. Because anaerobes generally are recovered mixed with aerobic organisms, the choice of appropriate antimicrobial should provide adequate coverage of both types of pathogen, as stated in 5. The use of metronidazole is still considered the criterion standard for therapy of anaerobic infections, as described in 6, and it is a cost-effective drug with good activity against pathogenic anaerobic bacteria.