Treatment failure of vaginal trichomoniasis in clinical practice

• Published in: International journal of STD & AIDS Vol. 16; no. 4; pp. 284 - 286
• Main Authors: DAS, Satyajit, HUENGSBERG, Mia, SHAHMANESH, Mohsen
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.04.2005; Royal Society of Medicine Press; Sage Publications Ltd
• Subjects: Administration, Oral; Administration, Topical; Adolescent; Adult; AIDS/HIV; Algorithms; Ambulatory Care Facilities; Amoxicillin - therapeutic use; Anti-Bacterial Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal agents; Antiprotozoal Agents - therapeutic use; Biological and medical sciences; Dose-Response Relationship, Drug; Drug Resistance; Drug Therapy, Combination; Epidemiology. Vaccinations; Female; General aspects; Human protozoal diseases; Humans; Infectious diseases; Medical sciences; Metronidazole - therapeutic use; Middle Aged; Parasitic diseases; Parasitic diseases due to ciliates and flagellates; Pharmacology. Drug treatments; Protozoal diseases; Retreatment; Retrospective Studies; Treatment Failure; Trichomonas vaginalis; Trichomonas Vaginitis - drug therapy; United Kingdom; British Isles; RESISTANCE; TREATMENT; METRONIDAZOLE; TRICHOMONAS VAGINALIS; Trichomonas vaginalis; Nitro compound; Imidazole derivatives; Protozoa; Protozoal disease; Vagina; Parasitosis; Trichomonadida; Infection; Resistance; Antiprotozoal agent; Antifungal agent; Sexually transmitted disease; Treatment; Trichomoniasis; Parasiticide; Metronidazole; Failure
• ISSN: 0956-4624; 1758-1052
• DOI: 10.1258/0956462053654258

We have conducted a retrospective study of treatment failure of Trichomonas vaginalis (TV) infection in a busy, urban genitourinary medicine clinic in Birmingham, UK, between 1998 and 2002. The prevalence of non-response to standard doses of metronidazole without any history of reinfection or nonadherence was 1.7% (28/1603) overall, and has significantly increased from 0.38% in 1999 to 3.5% in 2002 (P=0.001, χ2 test). There were no associated demographic factors. The majority of patients (53% or 15/28) responded to either a repeat of standard (10/26) or higher oral dose (5/7) of metronidazole. A standardized treatment algorithm using a high dose of metronidazole may be useful in the absence of any new, efficacious non-imidazole-based TV therapy in the clinical management of persistent TV infection.