Impaired elimination of metronidazole in decompensated chronic liver disease.

Impaired elimination of metronidazole in decompensated chronic liver diseaseMetronidazole is given to patients with liver disease because of its efficacy against anaerobic organisms.'Although relatively safe, it can cause uncomfortable gastrointestinal and neurological symptoms that may be related to prolonged high blood concentrations of the drug.'Cirrhotic livers have an impaired drug metabolising capacity,2 but two recent studies of elimination of metronidazole in liver disease have produced conflicting results.3We studied the disappearance of metronidazole from plasma in 10 patients with decompensated chronic liver disease and compared the results with those in nine healthy subjects.