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In a study conducted at the Bristol Royal Infirmary, Flagyl and neomycin were evaluated for one week in 11 patients with acute or chronic hepatic encephalopathy. Improvement in mental state, and reduction in tremors and bad breath were seen with both antibiotic drugs. Results suggest that generic metronidazole may be as effective as neomycin for hepatic encephalopathy. The use of Flagyl is recognized by the American College of Gastroenterology for patients with hepatic encephalopathy, but they recommend close, careful monitoring of the kidneys, nervous system, and the ears.
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Also, it may be used off-label to treat the tetanus bacteria. Compared with the antibiotic penicillin, generic Flagyl has similar or better antimicrobial activity. In a study comparing oral metronidazole to penicillin, metronidazole showed better survival, shorter hospitalization, and less progression of disease. Additionally, in four case studies by investigators in Saudi Arabia, people treated during and received both penicillin and Flagyl and had improved symptoms with these treatments.
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