Question special

With so many indications for use (BV, Trichomonas, Giardia, anaerobes), I have worked with many patients who are taking metronidazole. Almost universally, they feel miserable, with adverse GI side effects and the potential for disulfiram-like reactions. Metronidazole has been a standard treatment for years and doesn't seem to be going anywhere, but this begs the question as to whether other antibiotics may have utility in these cases.