Pharmacology · single question
What is the DRUG OF CHOICE for systemic treatment of ANUG when local debridement is insufficient?
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Correct answer: B. Metronidazole
- A. Amoxicillin has limited anaerobic coverage compared to metronidazole for ANUG-specific organisms. While it may be used in combination with metronidazole, it is not the drug of choice alone.
- B. CORRECT. Metronidazole (Flagyl) is the first-choice systemic antibiotic for ANUG. It has excellent activity against anaerobes (especially spirochetes and gram-negative anaerobes like Fusobacterium and Prevotella) — the exact organisms responsible for ANUG. Metronidazole combined with thorough local debridement is highly effective for ANUG.
- C. Azithromycin targets gram-positive cocci and atypical organisms — less effective against the primary anaerobic pathogens of ANUG.
- D. Clindamycin has excellent anaerobic coverage but is typically reserved for penicillin-allergic patients or more serious deep space infections. Metronidazole is preferred for ANUG.