European Journal of Pediatrics

, Volume 149, Issue 11, pp 792–796 | Cite as

The use of metronidazole in management of methylmalonic and propionic acidaemias

  • G. N. Thompson
  • R. A. Chalmers
  • J. H. Walter
  • J. L. Bresson
  • S. L. Lyonnet
  • P. J. Reed
  • J. M. Saudubray
  • J. V. Leonard
  • D. Halliday
Metabolic Diseases


Gut bacteria have been implicated as an important source of propionate in children with inborn errors of propionate metabolism. We have investigated the value of oral metronidazole (10–20 mg/kg per day) in five children with methylmalonic acidaemia (MMA) and four with propionic acidaemia (PA). Urinary excretion of propionate metabolites fell significantly during the treatment in all subjects, the mean decrease being 41% (range 12–76,P<0.01), while mean plasma propionate was reduced from 45.0 μmol/l to 25.1 μmol/l (P<0.05). Substantial reduction of the gut bacterial population was confirmed by lactulose breath hydrogen tests and by stool culture, and stool propionate concentration was reduced in most subjects. Clinical improvement was noted in three children. These results suggest that long-term antimicrobial therapy may offer significant clinical benefit to children with inborn errors of propionate metabolism.

Key words

Methylmalonic acidaemia Propionic acidaemia Metronidazole Gut bacteria Propionate 



gas chromatographic


methylmalonic acidaemia


propionic acidaemia


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Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • G. N. Thompson
    • 1
  • R. A. Chalmers
    • 2
  • J. H. Walter
    • 4
  • J. L. Bresson
    • 5
  • S. L. Lyonnet
    • 5
  • P. J. Reed
    • 3
  • J. M. Saudubray
    • 5
  • J. V. Leonard
    • 4
  • D. Halliday
    • 1
  1. 1.Nutrition Research GroupClinical Research CentreHarrowUK
  2. 2.Section of Perinatal and Child HealthClinical Research CentreHarrowUK
  3. 3.Microbial Pathogenicity Research GroupClinical Research CentreHarrowUK
  4. 4.Department of Child HealthInstitute of Child HealthLondonUK
  5. 5.Clinique de Génétique MedicaleHôpital des Enfants MaladesParisFrance

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