Persistent vaginitis caused by metronidazole‐resistant trichomonas

Jh, Grossman; Rp, Galask

doi:10.1016/0020-7292(91)90850-5

Cited by 11 publications

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“…Since the introduction of 5-nitroimidazoles in the 1960s there have been reports of at least 100 metronidazole-resistant strains of T. vaginalis from the United States (5,9,12,16,21,23,29,31,32,35). Only under 20 metronidazole-resistant strains have been described from Europe (3,7,12,16,19,26,40,41).…”

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Resistance of Trichomonas vaginalis to Metronidazole: Report of the First Three Cases from Finland and Optimization of In Vitro Susceptibility Testing under Various Oxygen Concentrations

et al. 2000

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Trichomonas vaginalis is a globally common sexually transmitted human parasite. Many strains of T. vaginalis from around the world have been described to be resistant to the current drug of choice, metronidazole. However, only a few cases of metronidazole resistance have been reported from Europe. The resistant strains cause prolonged infections which are difficult to treat. T. vaginalis infection also increases the risk for human immunodeficiency virus transmission. We present a practical method for determining the resistance of T. vaginalis to 5-nitroimidazoles. The suggested method was developed by determining the MICs and minimal lethal concentrations (MLCs) of metronidazole and ornidazole forT. vaginalis under various aerobic and anaerobic conditions. Using this assay we have found the first three metronidazole-resistant strains from Finland, although the origin of at least one of the strains seems to be Russia. Analysis of the patient-derived and previously characterized isolates showed that metronidazole-resistant strains were also resistant to ornidazole, and MLCs for all strains tested correlated well with the MICs. The suggested MICs of metronidazole for differentiation of sensitive and resistant isolates are >75 μg/ml in an aerobic 24-h assay and >15 μg/ml in an anaerobic 48-h assay.

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Resistance of Trichomonas vaginalis to Metronidazole: Report of the First Three Cases from Finland and Optimization of In Vitro Susceptibility Testing under Various Oxygen Concentrations

et al. 2000

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“…Tinidazole: This is another nitro-imidazole with cure rates similar to metronidazole, 10 which has been shown to achieve cure in cases of metronidazole failure. 33,34 One study reported cure rates of 92% in rTV using oral and vaginal tinidazole, which was well tolerated despite the high doses used. 35 Paromomycin cream: A topical treatment first used in 1964 36 with several successful case reports but frequent local side-effects, ranging from mild 37 to severe 38 vaginal ulceration.…”

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confidence: 99%

Recalcitrant Trichomonas vaginalis infection – a case series

et al. 2005

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The objective of this study was (1) to estimate the prevalence of recalcitrant Trichomonas vaginalis (TV) infection in a UK genitourinary medicine clinic; (2) to use a case series and literature review to suggest an algorithm for management of recalcitrant TV (rTV). A retrospective review of laboratory records, case-notes and literature review was conducted. Fifteen patients were studied, representing 1.16% of the cases presenting during the study period. A wide variety of therapeutic agents was used, the treatment regimen differed for each patient. No treatment was universally effective in achieving cure, but the use of acetarsol pessaries vaginally appeared to be the most frequently successful strategy. Based on these results, an algorithm for treatment of rTV is presented, although clinical trials will be needed to elucidate the best clinical approaches to this problem.

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“…Metronidazole has so far been the most widely used drug for treating this disease. However, metronidazole use can lead to drug resistance and potential risks of mutagenicity and carcinogenicity (Sobel et al 1999;Grossman and Galask 1990). In addition, the side effects of metronidazole such as headache, dry mouth, metallic taste, glossitis, and urticaria caused by lengthy treatment or high doses have also been described (Oxberry et al 1994;Kapoor et al 1999).…”

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confidence: 99%

Inhibitory effects of Thai plants β-glycosides on Trichomonas vaginalis

et al. 2008

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Trichomoniasis is now an important health problem in developing countries. Although metronidazole has so far been widely used to treat this disease, the prevalence of metronidazole-resistant protozoa and unpleasant adverse effects have been found. In this study, natural products purified from Thai plants were, therefore, investigated for their effectiveness against Trichomonas vaginalis. The minimal inhibitory concentrations for all beta-glycosides against Trichomonas vaginalis at 24 h were in a range of 6.25-12.5 microM. In addition, torvoside A and H were found to be more potent than their corresponding aglycones, deglucosylated torvoside A and H, while other beta-glycosides were generally as active as their corresponding aglycones. The cytotoxicity of these compounds was also determined. Except for dalcochinin, none of the tested compounds showed cytotoxicity against Vero and cancer cell lines (KB and MCF-7), having IC(50) values greater than 50 microg/ml. In conclusion, beta-glycosides and several aglycones showed selective inhibition against Trichomonas vaginalis without harmful effect to mammalian cells.

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Persistent vaginitis caused by metronidazole‐resistant trichomonas

Cited by 11 publications

References 0 publications

Resistance of Trichomonas vaginalis to Metronidazole: Report of the First Three Cases from Finland and Optimization of In Vitro Susceptibility Testing under Various Oxygen Concentrations

Resistance of Trichomonas vaginalis to Metronidazole: Report of the First Three Cases from Finland and Optimization of In Vitro Susceptibility Testing under Various Oxygen Concentrations

Recalcitrant Trichomonas vaginalis infection – a case series

Inhibitory effects of Thai plants β-glycosides on Trichomonas vaginalis

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