A comparative study of the effectiveness of metronidazole and penicillin V in eliminating anaerobes from postextraction bacteremias

Abstract

Recent reports have indicated the serious nature of anaerobic endocarditis and septicemia. As anaerobes can be isolated from postextraction bacteremias, this study was undertaken to evaluate the effectiveness of metronidazole and penicillin V in eliminating anaerobes from postextraction bacteremias. Twenty-five patients were randomly assigned to each of three groups--a placebo group, a metronidazole group, and a penicillin V group--for a total of seventy-five patients. Although penicillin V reduced the occurrence of anaerobes to a greater degree than did metronidazole, it was noted that gram-negative anaerobes were still detected in the blood of four patients in the penicillin V group. In the metronidazole group no gram-negative anaerobes were cultured. Because of the marked effectiveness of metronidazole against gram-negative anaerobes, the use of penicillin V and metronidazole in combination might be effective in the prevention of the sequelae of postextraction bacteremias. However, further studies, using a larger sample size, to investigate specifically gram-negative anaerobes are required.