Key Points
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Discusses clinical indications for metronidazole prescription.
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Documents a case with an unusual side effect after metronidazole prescription.
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Explores the literature for similar cases.
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Explains how to report adverse drug reactions if they occur.
Abstract
As a healthcare profession, dentists have a role in ensuring the safety of prescribed medicines by reporting adverse drug reactions using the Yellow Card Scheme. This article briefly describes a case where metronidazole, an antibiotic commonly prescribed by dentists, may have caused ototoxicity and explores the evidence around this. It also highlights the method for reporting such effects.
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References
Pallasch T J. Antibacterial and antibiotic drugs. In Yagiela J A et al. (eds) Pharmacology and therapeutics for dentistry. 6th ed. pp 600–639. St Louis: Elsevier, 2011.
Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. Available online at http://www.medicinescomplete.com/mc/bnf/current/PHP3647-metronidazole.htm (accessed February 2014).
Covvey J R, Johnson B F, Elliott V, Malcolm W, Mullen A B . An association between socioeconomic deprivation and primary care antibiotic prescribing in Scotland. J Antimicrobial Chemo 2014; 69: 835–841.
NHS. Prescription Cost Analysis England 2011. Leeds: Health and Social Care Information Centre, 2012. Available online at from. http://www.hscic.gov.uk/catalogue/PUB05807/pres-cost-anal-eng-2011-rep.pdf (accessed March 2016).
NHS. Prescribing by Dentists, England – 2011. Leeds: Health and Social Care Information Centre; 2012. Available online at http://www.hscic.gov.uk/catalogue/PUB05841/pres-dent-eng-2011-rep.pdf (accessed March 2016).
Scottish Dental Clinical Effectiveness Programme. Drug prescribing for dentistry: dental clinical guidance. 2011. Available online at http://www.sdcep.org.uk/?o=2334 (accessed March 2016) .
Herrera D, Sanz M, Jepsen S, Needleman I, Roldan S . A systematic review on the effect of systemic antimicrobials as an adjunct to scaling and root planing in periodontitis patients. J Clin Perio 2002; 29 (Suppl 3): 136–159.
Haffajee A D, Socransky S S, Gunsolley J C . Systemic anti-infective periodontal therapy: a systematic review. Ann Perio 2003; 8: 115–181.
Sgolastro F, Severino M, Petrucci A, Gatto R, Monaco A . Effectiveness of metronidazole as an adjunct to scaling and root planing in the treatment of chronic periodontitis: a systematic review and meta-analysis. J Perio Res 2014; 49: 10–19.
Kuriyama A, Jackson J L, Doi A, Kamiya T . Metronidazole-induced central nervous system toxicity: a systematic review. Clin Neuropharmacology 2011; 34: 241–247.
Cianfrone G, Pentangelo D, Cianfrone F et al. Pharmacological drugs inducing ototoxicity, vestibular symptoms and tinnitus: a reasoned and updated guide. Euro Rev Med Pharmacol Sci 2011; 15: 601–636.
Hibberd A D, Nicoll R J, Macbeth W A . Deafness is an adverse drug reaction to metronidazole. New Zealand Med J 1984; 97: 128.
Iqbal S M, Murthy J G, Banerjee P K, Vishwanathan K A . Metronidazole ototoxicity – report of two cases. J Laryngology Otology 1999; 113: 355–357.
Jafari G, Hosseini S M, Akhondzadeh S . Sudden hearing loss subsequent to diarrhoea: what is the missing link? DARU J Pharmaceutical Sci 2014; 22: 15–17.
Stachler R J, Chandrasekhar S S, Archer S M et al. Clinical Practice Guideline: sudden hearing loss. Otolaryngol Head Neck Surg 2012; 146 (Suppl 3): S1–S35.
Riggs L C, Shofner W P, Shah A R, Young M R, Hain T C, Matz G J . Ototoxicity resulting from combined administration of metronidazole and gentamicin. Am J Otology 1999; 20: 430–434.
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O'Donnell, K., Barker, D. Metronidazole and tinnitus: A potential side effect?. Br Dent J 220, 289–291 (2016). https://doi.org/10.1038/sj.bdj.2016.218
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DOI: https://doi.org/10.1038/sj.bdj.2016.218
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