Family Nurse Practitioner Exam

Which patient condition does not require the use of metronidazole?

1. Mild Clostridium difficile colitis

2. Acute diverticulitis

3. Pelvic inflammatory disease

4. Gas gangrene

The correct answer is: Acute diverticulitis

Acute diverticulitis does not typically require the use of metronidazole as part of its treatment regimen. The standard management for uncomplicated diverticulitis primarily involves dietary modifications and possibly the use of antibiotics that often include fluoroquinolones or beta-lactams, but metronidazole is not routinely indicated unless there are abscesses or complications. On the other hand, metronidazole is an effective treatment for conditions like mild Clostridium difficile colitis, pelvic inflammatory disease, and gas gangrene, as it targets anaerobic bacteria and certain protozoa. In the case of mild C. difficile infection, guidelines recognize metronidazole as a first-line agent. Similarly, metronidazole is part of the recommended antibiotic therapy for pelvic inflammatory disease due to its efficacy against anaerobes. Lastly, for gas gangrene, caused by Clostridium species, metronidazole is clearly indicated as it has strong activity against these infections and is crucial in managing such life-threatening conditions. Thus, among the listed conditions, acute diverticulitis is the one that does not require metronidazole in its standard management.