THEODORE A. ALSTON, M.D., Ph.D.
To the editor: In their review of antibiotic neurotoxicity, Snavely and Hodges (1) mention that the neurotoxicity of isoniazid stems largely from antagonism of vitamin B6. However, they point out that the mechanisms of central and peripheral neurotoxicity of metronidazole are not understood. This problem is vexing because adverse neurologic reactions limit the chronic use of metronidazole in the control of Crohn disease and limit use of high-dose metronidazole for control of life-threatening anaerobic infections or radiosensitization of tumors (1, 2).
The neurotoxicity of metronidazole may involve metabolic reduction of its nitro substituent, in which case the neurotoxic action may
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ALSTON TA. Neurotoxicity of Metronidazole. Ann Intern Med. 1985;103:161. doi: 10.7326/0003-4819-103-1-161_1
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Published: Ann Intern Med. 1985;103(1):161.
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