Een toediening van metronidazol (Flagyl) aan een kind van 2 jaar met behulp van siroop of capsule lukt niet. Het kind geeft over. Zijn zetpillen een alternatief?

Volgende referenties wijzen op de mogelijkheid tot gebruik van de rectale toediening.
Blijkbaar is het gebruik van een PEG basis aangewezen. Maar het valt af te wachten hoe een kind zal reageren op zetpillen met PEG , waarvan al eens gezegd wordt dat ze laxerend werken en moeilijk op te houden zijn.

Rectal Administration of Metronidazole Provides Therapeutic Plasma Levels in Postoperative Patients

Lisa Ioannides, B.Pharm., Andrew Somogyi, Ph.D., John Spicer, M.B., Birger Heinzow, M.D., Nicholas Tong, B.Pharm., Clare Franklin, B.Sc., and Allan McLean, M.B., Ph.D.
N Engl J Med 1981; 305:1569-1570December 24, 1981

Metronidazole has been widely used for prophylaxis and therapy of anaerobic infections in abdominal and gynecologic surgery.1 2 3 4 Although clinical trials have demonstrated the efficacy of suppository formulations of metronidazole,5 6 7 8there have been no reports on rectal absorption of this drug and steady-state concentrations in the plasma of post-operative patients, particularly those with altered bowel motility or sepsis within the abdominal or pelvic cavity. Expensive intravenous preparations of metronidazole are therefore widely used. We show that rectal administration provides adequate therapeutic plasma levels after surgery.

Rectal absorption of metronidazole from polyethylene glycol suppositories.

by H Vromans, F Moolenaar, J Visser, D K Meijer

The rectal absorption of metronidazole from an aqueous suspension, a fatty suppository and three different polyethylene glycol suppositories was studied in healthy volunteers and compared with absorption from an oral solution. Rectal absorption was found to be rather slow for all suppositories. Of all rectal dosage forms, the polyethylene glycol suppositories gave the highest peak plasma levels and the highest relative bioavailability. Compared with oral administration, a relative bioavailability of 80% could be obtained.