Barbulescu A, et al. - In this population-based case-control study, researchers studied the relationship of single and combined regimens of oral metronidazole with acute pancreatitis risk according to the timing of the latest metronidazole prescription prior to hospitalization. They identified all people in Sweden (aged 40–84 years) hospitalized with acute pancreatitis from January 2006 to December 2008 from a national hospital register (n=5,996). They found an increased acute pancreatitis risk within 30 days of exposure to single and combined regimens of oral metronidazole, supported by a self-controlled case series analysis. No strong association was found between oral metronidazole and acute pancreatitis more than 30 days following exposure. Reverse causality and confounding by indication can't be completely discounted, but those factors probably can’t completely account for the relationship. These findings support the evidence of a positive relationship between oral metronidazole and acute pancreatitis risk, which merits an increased awareness among practitioners.