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Metronidazole
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==Evidence== No clinical trials of metronidazole have been done for chronic fatigue syndrome. Metronidazole is FDA-approved for: * protozoal infections such as Trichomoniasis vaginalis, Entamoeba histolytica, [[Giardia]] lamblia, blastocysts, and Balantidium coli. * anaerobic [[bacteria]]l infections caused by Bacteroides species, Fusobacterium species, [[Clostridium]] species, Gardnerella vaginalis, [[Helicobacter pylori]], Prevotella species, Porphyromonas species, and Biophilia Wadsworth.<ref name="StatPearls"/> Metronidazole is FDA-approved and widely used to treat a broad range of infections including intestinal amebiases, liver amebiasis, bacterial septicemia, bone and joint infections, central nervous system infections (e.g., meningitis and brain abscess), endocarditis, gynecologic infections (e.g., endometritis, tubo-ovarian abscess, bacterial vaginosis), intra-abdominal infections, lower respiratory tract infections, skin structure infections, and as a preventative drug before colorectal surgery.<ref name="StatPearls"/> In a study comparing [[rifaximin]] to metronidazole, the overall prevalence of adverse events was significantly lower in the rifaximin group than the metronidazole group. Rifaximin showed a higher SIBO decontamination rate than metronidazole. But neither of the drugs seemed to represent a good choice for the management of patients affected by [[Small intestinal bacterial overgrowth|SIBO]].<ref name="Lauritano2009">{{Cite journal|title=Antibiotic therapy in small intestinal bacterial overgrowth: rifaximin versus metronidazole|date=2009|url=https://pubmed.ncbi.nlm.nih.gov/19499846/|journal=European Review for Medical and Pharmacological Sciences|volume=13|issue=2|pages=111β116|last=Lauritano|first=E. C.|last2=Gabrielli|first2=M.|last3=Scarpellini|first3=E.|last4=Ojetti|first4=V.|last5=Roccarina|first5=D.|last6=Villita|first6=A.|last7=Fiore|first7=E.|last8=Flore|first8=R.|last9=Santoliquido|first9=A.|last10=Tondi|first10=P.|last11=Gasbarrini|first11=G.|pmid=19499846|issn=1128-3602}}</ref>
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