Intravenous (IV) metronidazole is commonly prescribed in the management of intra-abdominal sepsis in hospital. Metronidazole has excellent oral bioavailability (95-100%). In addition to improved stewardship, the oral route provides advantages in terms of reduced patient risk, earlier discharge, reduced staff workload, reduced costs and environmental benefits. The aim of this project was to increase the use of oral metronidazole where appropriate in surgical patients at the Royal Alexandria Hospital by 50% from baseline. A quality improvement approach was used to raise awareness and engagement with the multidisciplinary surgical team. A range of methods were used including prospective audit and feedback, departmental presentations, ward posters, staff champions and recognition awards. Ten months after starting the project oral metronidazole use has increased from a 7% baseline to 51% post change surpassing the original target. This project is ongoing.