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How Long Do The Side Effects Of Flagyl Remain?

Posted on Mon, 14 Sep 2015

Question: Hi my 13 year daughter has been on 400 flagyl three times a day for ten weeks ? How long will her side affects last that are very similar to her original complaint of sore tummy and tired

Answered by Dr. Pradeep Kumar Jain (48 minutes later)

Brief Answer:
Please provide details

Detailed Answer:
Hello

Thanks for asking on this platform

I am surprised for which condition she is taking flagyl(metronidazole) for 10 weeks.There are few condition like amebic liver abscess where 3-4 weeks treatment of metronidazole is given.
Please provide me the details like symptoms and diagnosis.
The side effect of metronidazole is abdominal discomfort,liver derangement,dizziness,numbness etc.
Once the medication stopped the symptoms usually resolve within 7-10 days till the time of clearance from blood.

Waiting for your response.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (39 minutes later)

Sorry it was ten days and I don't think you got the extra info which was that she had a faecal multiplex pcr and was found to have blastocyst a hominis and dientamoeba fragilis. Is it still 7 to ten days

Answered by Dr. Pradeep Kumar Jain (2 hours later)

Brief Answer:
Side effect should subside within 48 hours after stopping the medicine

Detailed Answer:
Thanks for writing back

I mentioned 7-10 days in my last answer considering the cumulative affect of 10 weeks.
In current scenario the side effect should subside within 48 hours of stopping the medication.
I would suggest you to give her some probiotic to maintain the normal gut flora.

I shall be glad to answer if you have any more query.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (51 minutes later)

What is your view of faecal multiplex pcr testing. She was also diagnosed with camylabacter and shigella. The bacteria result came eight days after parasite result for the same stool sample so then she was retested with the traditional stool testing all were not found. She has never had diarrhoea during her two / three month illness period. She doesn't have glandular fever or its cousin, she didn't test positive for diabetes, nor hep a. Her bloods are fine-ish. First done before first stool test showed red blood cell were slightly below and phosphate high but all else within healthy range. No liver test done. Second bloods fine except this time liver enzymes were done and were slightly elevated. She was negative for gluten allergy dna was negative and nutripath result for food reactions showed not much reaction to gluten. Did show a reaction to egg but she hasn't had any since then and that result cam in about a month ago. Any thoughts

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Fecal multiplex pcr is a very senstive test

Detailed Answer:
Thanks for follow up

Fecal multiplex PCR test is a method to detect intestinal bacteria present in stool.The normal gut contains many bacteria and PCR test detects only the pathogenic bacteria.
The sensitivity of PCR test to detect the bacteria is 100 %,while it varies from 20-90% in traditional test.That is the reason the traditional stool test is normal while PCR is positive in your daughter's case.
Blastocyst a hominis and Dientamoeba fragilis are protozoa. Flagyl(metronidazole) must be given to your daughter to eliminate these protozoas from intestine.10 days course of flagyl is sufficient for protozoal infection.
Shigella is a normal inhabitant of intestine (may cause dysentery in few conditions)and does not need any treatment in absence of symptoms. Campylobactor when present in stool should be treated with antibiotic.
All these organisms can cause variety of symptoms ranging from mild symptoms to severe bloody dysentery.
Ciprofolxacin and azithromycin both has good coverage for campylobactor and shigella.
I would suggest you to consult your pediatrician and discuss about the need of antibiotic treatment.
I wont get worried for slightly low count of RBC,high phosphate and slightly elevated liver enzymes if other blood reports are normal.
You have given details of investigation,but I would like to know the detail history like what are the symptoms she is suffering from and for how long.
If the same condition persist even after antibiotic treatment and symptoms are suggestive of some inflammatory disorder endoscopic or colonoscopic evaluation may be needed.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (1 hour later)

Is it try that the camplabactor could be in a dead form from food she had eaten?

Answered by Dr. Pradeep Kumar Jain (30 minutes later)

Brief Answer:
You are right,but treatment will be needed

Detailed Answer:
I really appreciate your knowledge.
You are right the multiplex PCR can not differentiate between the live and dead bacteria.
It might be possible that the PCR has detected a dead campylobactor.
There are advance methods which can differentiate the dead and live bacteria.
But in the present scenario where the child is symptomatic with positive PCR and symptoms are suggestive of intestinal infection I would like to treat the condition.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar