George R, Prasoona TS, Kandasamy R, et al. - Researchers assessed the link between maintenance metronidazole and the incidence of malignant fistulae in recurrent cervical cancer in this retrospective cohort study utilizing the local palliative care database at Christian Medical College, Vellore, India. A total of 208 eligible patients with residual/recurrent pelvic disease after treatment were identified. Oral maintenance metronidazole 200 mg was administered once daily for 2-86 weeks to 76 patients. Fewer fistulae, a longer median fistula-free survival, and a post-recurrence survival of 11.5 months vs 8.7 months were observed in patients on maintenance metronidazole. A higher risk of fistula was observed in relation to bladder/rectal infiltration, whereas a higher risk of death was reported in relation to distant metastases and Eastern Cooperative Oncology Group performance status of > 1. Findings revealed a significant inverse link between oral maintenance metronidazole and malignant fistulae in locally recurrent cervical cancer.