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One hundred five patients with advanced pulmonary tuberculosis were studied; randomly 59 were given metronidazole (400 mg t.i.d.) and 46 given identical placebo for four weeks. Except for more drug sensitive strains in placebo group there were no differences between two groups. In 31 patients (30%) anaerobes (esp. Bacteroides) were isolated; in 7 of 18 patients who died anaerobes had a significant role. There was greater reduction in sputum production with metronidazole but overall clinical (65-68%) and radiographic (53-60%) improvements were similar in both groups. The post drug sensitivity pattern of tubercle bacilli became more favourable in metronidazole as compared to placebo group (P<0.05). This finding needs to be further studied.
