Tinidazole, like the structurally-related
drug metronidazole, was initially introduced for treating protozoal
infections. However, both these
nitroimidazole compounds are also active in vitro against most clinically important obligate anaerobes. Most of the clinical experience with
tinidazole to date has involved prophylactic use to prevent postoperative anaerobic
infection. Prospective placebo-controlled studies demonstrated that a single dose of
tinidazole administered orally prior to elective colorectal surgery significantly reduced postoperative
infection. Similarly, when given intravenously prior to
appendectomy,
tinidazole reduced the incidence of postoperative
infection in some subgroups of patients. Although results of non-blinded studies with prophylactic
tinidazole were encouraging when used in women undergoing gynaecological surgery (mainly
hysterectomy), results from double-blind placebo-controlled studies in this situation have been somewhat equivocal. Thus, although the overall weight of evidence suggests that the
drug is effective in this area of use, further study is needed to clarify its role in preventing anaerobic
infection following gynaecological surgery compared with other
antibiotics which can also be used for this purpose. Relatively few studies have been conducted with
tinidazole in the treatment of established anaerobic
infections, and this is an area needing further investigation. The
drug is well tolerated when administered orally or intravenously.