Tinidazole: from protozoa to Helicobacter pylori--the past, present and future of a nitroimidazole with peculiarities.

Tinidazole (Fasigyn, Pfizer Ltd), like metronidazole - to which it is structurally related - was initially introduced for treating protozoal infections. However, both of these nitroimidazole compounds are active against most clinically important obligate anaerobes. In the last few years, the discovery of Heliobacter pylori and of its susceptibility to nitroimidazoles focused new attention on these drugs. Tinidazole, as a part of this class of drugs, shares the characteristics and indications of other nitroimidazoles. However, it has a number of desirable features that could potentially make it very successful: a better pharmacokinetic and pharmacodynamic profile, a better safety and tolerability spectrum, and a preserved activity against some bacteria that are resistant to metronidazole.