The Sound of Evolution
Metronidazole
Mechanism of action:
Metronidazole is a 5-nitroimidazole derivative. Metronidazole itself is a prodrug. After entering anaerobic bacterial or protozoal cells, its nitro (-NO₂) group is reduced by microbial low-oxygen reductive enzymes, such as the pyruvate-ferredoxin oxidoreductase system, generating highly reactive nitro radical intermediates. These activated radicals bind to DNA, causing DNA strand breaks and interfering with DNA replication and transcription, ultimately leading to cell death.
Reference(s):
1. Shennan A et al. (2006). A randomised controlled trial of metronidazole for the prevention of preterm birth in women positive for cervicovaginal fetal fibronectin: the PREMET Study. BJOG.
2. Williams CS et al. (2000). Do ethanol and metronidazole interact to produce a disulfiram-like reaction? Ann Pharmacother.
3. Visapaa JP et al. (2002). Lack of disulfiram-like reaction with metronidazole and ethanol. Ann Pharmacother.