Skip to content
AMR Drug RepurposingSmart Screeningresearch prototype

Metronidazole

FDA-approved product (tablet, oral), marketed as Flagyl, Flagyl Er, Flagyl I.v. Rtu In Plastic Container and 17 more.

Registered studies
12
Lab records
14
Pathogens at ≥40%
0 of 4

Chemical structure

Chemical structure of Metronidazole
A drawing shows what the molecule is, not what it does.

Existing / approved use

Documented · FDA, WHO, ChEMBL

Approved for

  • Amebiasis
  • Bacterial disease
  • Bacterial vaginosis
  • Duodenal ulcer
  • Endocervicitis
  • Infection
  • Pneumonia
  • Rosacea
  • Sepsis
  • Trichomoniasis

Indications ChEMBL records as approved, from FDA and DailyMed labels. Label ↗

WHO therapeutic group
Antiinfectives and antiseptics for local oral treatment; Other chemotherapeutics; Imidazole derivatives; Nitroimidazole derivatives
FDA pharmacologic class
Nitroimidazole Antimicrobial FDA label ↗
Anti-infective classification
Classified as an existing antimicrobial.WHO ATC J01XD01

Repurposing investigation

Metronidazole is already an antimicrobial, so it is not counted among the repurposing candidates. Its AI-predicted activity is shown below for reference.

AI-predicted activity

AI prediction · nothing measured
  • MRSA3.4% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates. This medicine was in the model's training data, so this is recall, not a new prediction.
  • E. coli4.2% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates. This medicine was in the model's training data, so this is recall, not a new prediction.
  • K. pneumoniae6.3% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates. This medicine was in the model's training data, so this is recall, not a new prediction.
  • M. tuberculosis2.0% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates. This medicine was in the model's training data, so this is recall, not a new prediction.

A model’s estimate of laboratory activity against each pathogen species. It is not clinical effectiveness.

Evidence

Clinical and experimental

Documented evidence

Clinical

12registered studies name this medicine, for any condition. See them below.

Experimental

  • MRSA: measured active in 0 of 1 lab record
  • E. coli: measured active in 0 of 6 lab records
  • K. pneumoniae: measured active in 0 of 1 lab record
  • M. tuberculosis: measured active in 0 of 6 lab records
Open Metronidazole in ChEMBL Registered studies below
Show the 14 laboratory records, with sources

Loading records…

“Active” means the measured value reached this project’s laboratory cutoff (10 µM or stronger). A laboratory result does not show an effect in patients.

Docking

Computational · nothing measured

Dihydrofolate reductase ↗ (E. coli)

Not yet docked: queued in the docking rundetails

KPC-2 carbapenemase ↗ (K. pneumoniae)

Not yet docked: queued in the docking rundetails

Enoyl-ACP reductase (InhA) ↗ (M. tuberculosis)

Not yet docked: queued in the docking rundetails

Dihydrofolate reductase ↗ (MRSA)

Not yet docked: queued in the docking rundetails

AutoDock Vina, one experimentally solved protein per pathogen. This project’s screening target is -7.0 kcal/mol, its own mark rather than a universal cutoff. A docking score is a structural hypothesis, not proof of binding, and requires experimental validation.

Other medicines to investigate

AI prediction · nothing measured

Other repurposing candidates: approved medicines besides Metronidazole with AI-predicted activity ≥40% against the chosen pathogen, leaving out existing antimicrobials. They are computational candidates for further investigation, not alternatives and not recommendations.

Sorted by AI-predicted activity, high to low. The order is not a ranking of which medicine is better.

Registered studies

A registration describes a study; it does not establish a positive result.

  • Pylori Duo for Adjunctive Treatment and Prevention of Recurrence of Helicobacter Pylori Infection

    NCT07729293 · start 2026-08-31

    Registered record
    Registry ID
    NCT07729293
    Conditions
    Helicobacter Pylori Infection; Dyspepsia; Gastrointestinal Adverse Effects
    Interventions
    Omeprazole; Pylera (Bismuth subcitrate potassium, metronidazole, tetracycline) given in combination with omeprazole; Pylori Duo; Placebo
    Study type
    INTERVENTIONAL
    Phase
    Not applicable
    Registry status
    Not yet recruiting
    Start
    2026-08-31
    Completion
    2028-09-30
    Enrolment
    140

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHelicobacter Pylori Infection; Dyspepsia; Gastrointestinal Adverse Effects
    InterventionOmeprazole; Pylera (Bismuth subcitrate potassium, metronidazole, tetracycline) given in combination with omeprazole; Pylori Duo; Placebo
    PhaseNot applicable
    Registry statusNot yet recruiting

  • Perioperative Oxaliplatin With S-1 Combined H. Pylori Eradication in the Management of Locally Advanced Gastric Cancer

    NCT06510010 · start 2024-12-31

    Registered record
    Registry ID
    NCT06510010
    Conditions
    Chemotherapy Effect
    Interventions
    Oxaliplatin With S-1 (SOX) Combined H. Pylori Eradication (Amoxicillin + clarithromycin + omeprazole + colloidal bismuth subcitrate); Oxaliplatin With S-1 （SOX）
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Recruiting
    Start
    2024-12-31
    Completion
    2027-07-31
    Enrolment
    198

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionChemotherapy Effect
    InterventionOxaliplatin With S-1 (SOX) Combined H. Pylori Eradication (Amoxicillin + clarithromycin + omeprazole + colloidal bismuth subcitrate); Oxaliplatin With S-1 （SOX）
    PhasePhase 2
    Registry statusRecruiting

  • Bismuth for PCAB-based H. Pylori Eradication

    NCT05453994 · start 2020-03-01

    Registered record
    Registry ID
    NCT05453994
    Conditions
    H. Pylori Infection
    Interventions
    H. pylori eradication
    Study type
    OBSERVATIONAL
    Phase
    Not recorded
    Registry status
    Completed
    Start
    2020-03-01
    Completion
    2023-08-31
    Enrolment
    150

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionH. Pylori Infection
    InterventionH. pylori eradication
    PhaseNot recorded
    Registry statusCompleted

  • Low Dose Bismuth Versus Lactobacillus Reuteri for H. Pylori Eradication

    NCT03925818 · start 2017-08-29

    Registered record
    Registry ID
    NCT03925818
    Conditions
    Helicobacter Pylori Infection
    Interventions
    Bismuth Subcitrate Potassium; Gastrus
    Study type
    INTERVENTIONAL
    Phase
    Not applicable
    Registry status
    Terminated
    Start
    2017-08-29
    Completion
    2018-12-23
    Enrolment
    99

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHelicobacter Pylori Infection
    InterventionBismuth Subcitrate Potassium; Gastrus
    PhaseNot applicable
    Registry statusTerminated

  • Comparison of TAK-438 (Vonoprazan) to Lansoprazole in the Treatment of Gastric Ulcer Participants With or Without Helicobacter Pylori Infection

    NCT03050307 · start 2017-04-17

    Registered record
    Registry ID
    NCT03050307
    Conditions
    Gastric Ulcer
    Interventions
    TAK-438; Lansoprazole; TAK-438 Placebo; Lansoprazole Placebo; Bismuth-Containing Quadruple Therapy
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Completed
    Start
    2017-04-17
    Completion
    2020-05-26
    Enrolment
    234

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionGastric Ulcer
    InterventionTAK-438; Lansoprazole; TAK-438 Placebo; Lansoprazole Placebo +1 more
    PhasePhase 3
    Registry statusCompleted

  • Comparison of TAK-438 (Vonoprazan) to Lansoprazole in the Treatment of Duodenal Ulcer Participants With or Without Helicobacter Pylori Infection

    NCT03050359 · start 2017-04-05

    Registered record
    Registry ID
    NCT03050359
    Conditions
    Duodenal Ulcer
    Interventions
    TAK-438; Lansoprazole; TAK-438 Placebo; Lansoprazole Placebo; Bismuth-Containing Quadruple Therapy
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Completed
    Start
    2017-04-05
    Completion
    2019-07-19
    Enrolment
    533

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionDuodenal Ulcer
    InterventionTAK-438; Lansoprazole; TAK-438 Placebo; Lansoprazole Placebo +1 more
    PhasePhase 3
    Registry statusCompleted

  • The Efficacy of the 7 Days Tailored Therapy as the 1st Eradication of H. Pylori Infection

    NCT02373280 · start 2014-08

    Registered record
    Registry ID
    NCT02373280
    Conditions
    Helicobacter Infection
    Interventions
    10 day sequential therapy (Esomeprazole, amoxicillin, clarithromycin, metronidazole); 7 day tailored PPI triple therapy (clarithromycin-containing triple therapy); 7 day moxifloxacin based triple therapy [Esomeprazole, Moxifloxacin, Amoxicillin]; 7 or 14 days tailored EBMT therapy group (bismuth quadruple therapy)
    Study type
    INTERVENTIONAL
    Phase
    Not applicable
    Registry status
    Recruiting
    Start
    2014-08
    Completion
    2027-12
    Enrolment
    600

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHelicobacter Infection
    Intervention10 day sequential therapy (Esomeprazole, amoxicillin, clarithromycin, metronidazole); 7 day tailored PPI triple therapy (clarithromycin-containing triple therapy); 7 day moxifloxacin based triple therapy [Esomeprazole, Moxifloxacin, Amoxicillin]; 7 or 14 days tailored EBMT therapy group (bismuth quadruple therapy)
    PhaseNot applicable
    Registry statusRecruiting

  • Helicobacter Pylori and Body Iron in Adults

    NCT03146325 · start 2012-11

    Registered record
    Registry ID
    NCT03146325
    Conditions
    Helicobacter Pylori Infection
    Interventions
    BISMUTH TETRACYCLINE METRONIDAZOLE OMEPRAZOLE; MATCHING PLACEBO
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Withdrawn
    Start
    2012-11
    Completion
    2016-08
    Enrolment
    0

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHelicobacter Pylori Infection
    InterventionBISMUTH TETRACYCLINE METRONIDAZOLE OMEPRAZOLE; MATCHING PLACEBO
    PhasePhase 4
    Registry statusWithdrawn

  • H. Pylori Eradication Using Pyklear in Adults in El Paso, Texas: a Pilot Study

    NCT01335334 · start 2011-03

    Registered record
    Registry ID
    NCT01335334
    Conditions
    H. Pylori Infection
    Interventions
    bismuth subcitrate potassium, metronidazole,tetracycline hydrochloride and omeprazole
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Unknown
    Start
    2011-03
    Completion
    2011-08
    Enrolment
    50

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionH. Pylori Infection
    Interventionbismuth subcitrate potassium, metronidazole,tetracycline hydrochloride and omeprazole
    PhasePhase 4
    Registry statusUnknown

  • Safety, Efficacy of Pylera BID Dosing in Eradication of H. Pylori

    NCT00712413 · start 2008-08

    Registered record
    Registry ID
    NCT00712413
    Conditions
    Helicobacter Pylori Infection
    Interventions
    OBMT
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Withdrawn
    Start
    2008-08
    Completion
    2008-12
    Enrolment
    0

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHelicobacter Pylori Infection
    InterventionOBMT
    PhasePhase 3
    Registry statusWithdrawn

  • Efficacy and Safety of Quadruple Therapy in Eradication of H. Pylori: A Comparison to Triple Therapy

    NCT00669955 · start 2008-06

    Registered record
    Registry ID
    NCT00669955
    Conditions
    Helicobacter Infections
    Interventions
    Omeprazole, amoxicillin, clarithromycin; Pylera (Bismuth subcitrate potassium, metronidazole, tetracycline) given in combination with omeprazole
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Completed
    Start
    2008-06
    Completion
    2009-08
    Enrolment
    440

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHelicobacter Infections
    InterventionOmeprazole, amoxicillin, clarithromycin; Pylera (Bismuth subcitrate potassium, metronidazole, tetracycline) given in combination with omeprazole
    PhasePhase 3
    Registry statusCompleted

  • Quadruple Therapy for Triple Therapy Resistant Helicobacter Pylori Infection

    NCT00520949 · start 2006-10

    Registered record
    Registry ID
    NCT00520949
    Conditions
    Treatment of Helicobacter Pylori
    Interventions
    Augmentin (Amoxicillin-clavulanic); Furoxone (furazolidone); Cebes (colloidal bismuth subcitrate); Esso (esomeprazole)
    Study type
    INTERVENTIONAL
    Phase
    Not applicable
    Registry status
    Completed
    Start
    2006-10
    Completion
    2008-06
    Enrolment
    176

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionTreatment of Helicobacter Pylori
    InterventionAugmentin (Amoxicillin-clavulanic); Furoxone (furazolidone); Cebes (colloidal bismuth subcitrate); Esso (esomeprazole)
    PhaseNot applicable
    Registry statusCompleted