Metronidazole inhibits E. histolytica, G. lamblia, T. vaginalis, Blastocystis hominis, B. coli, and the helminth Dracunculus medinensis. It is also bactericidal for obligate anaerobic gram-positive and gram-negative bacteria except Actinomyces spp. It is not active against aerobes or facultative anaerobes. Drug resistance is infrequent; the mechanism of resistance is not understood. Tinidazole, a 5-nitroimidazole closely related to metronidazole, is effective against vaginal trichomonia-sis resistant to metronidazole.
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