Metronidazole-resistant Trichomonas vaginalis.

Abstract

SUMMARY A 36-year-old woman with symptomatic metronidazole-resistant trichomonal vaginitis for 10 years had a total of 22 courses of treatment with either metronidazole or tinidazole according to different schedules. The minimum trichomonicidal concentration of metronidazole for the strain of Trichomonas vaginalis isolated from the patient was 160 ,ug/ml compared with 1 25-10 mg/ml for other freshly isolated strains. The former strain also showed a definitely decreased sensitivity to ornidazole and tinidazole (80 mg/ml). The mechanisms behind the appearance of resistance in this clinical isolate are at present unknown and require further study from the theoretical as well as the therapeutic viewpoint.

Low prevalence of chlamydial endocervical infection in antenatal south Indian women.

“…As a consequence, our results suggest that a large proportion of Italian HBSAg carriers are unaware of their condition. The estimated prevalence of HBsAg carriers in Italy lies between 2% and 4% (2)(3); and, based on our results, 1.2-2.5 % of Italian people (about 700 000-1 400 000 subjects) may be unaware of their HBsAg carrier status, with obvious consequences in terms of public health, that is, diffusion of HBV infection. We have tested the in vitro susceptibility to metronidazole of 41 freshly isolated local strains of Trichomonas vaginalis at Jos University Teaching Hospital, Nigeria to determine the possible emergence of resistant strains in our locality.…”

Determination of the viability of trichomonas vaginalis using flow cytometry

“…Trichomoniasis is treated routinely by metronidazole (22) and other 5'nitro-imidazole derivatives. A single course of treatment can result in a 10% failure rate, and this results in a n enormous number of patients when one considers the prevalence of infection (10% in a London clinic, 30% in developing countries) (4,12). These patients are subsequently cured with larger doses of metronidazole (9,221; however, there is concern about the safety of giving certain patients repeated courses of the drug at such high doses.…”

In vitro susceptibility of Trichomonas vaginalis to 50 antimicrobial agents

“…Increased dosage, intravenous therapy, and prolonged oral therapy with metronidazole have been variably successful in treating resistant strains (2,15). This is not surprising, since the peak level of metronidazole in serum after oral administration of a 500-mg dose is 10 pug/ml and it is approximately 40 ,ug/ml after a 2-g dose; the MICs for resistant trichomonads have been reported to vary between 50 and 250 ,ug/ml (4,9,20). Other therapies that have been used include applications to the vagina of furazolidone and clotrimazole, as well as vinegar douches.…”

“…The most effective drug for the treatment of T. vaginalis vaginitis is metronidazole, but because of concern with the carcinogenic and teratogenic potential, there has been a search for alternative therapies (3,7,16). T. vaginalis strains that are somewhat resistant to metronidazole were also recently isolated, adding to the obvious need for new antitrichomonal agents (4,8,12,14,15). The standard regimen for susceptible trichomonads is 250 mg of metronidazole three times daily for 7 days or a single 2-g dose, but for resistant strains no uniform therapeutic strategy has been established (11,15).…”