Recalcitrant Trichomonas Vaginalis Infections Successfully Treated With Vaginal Acidification

Aggarwal, Anjali; Shier, R. Michael

doi:10.1016/s1701-2163(16)32714-1

Cited by 28 publications

(22 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, there has been a recent case report of drug resistant trichomoniasis being treated successfully with a combination therapy using paromomycin intravaginal cream administered nightly plus oral tinidazole dosed at 1 g three times a day for 14 days 24. A second case report has also found success with intravaginal boric acid used for 1 and 5 months, respectively, in two patients who tolerated this therapy well 25. Susceptibility testing for metronidazole and tinidazole is available in consultation with the Centers for Disease Control but may not always correlate with clinical outcome 15 20…”

mentioning

confidence: 99%

The clinical spectrum ofTrichomonas vaginalisinfection and challenges to management

Muzny

Schwebke

2013

Sex Transm Infect

View full text Add to dashboard Cite

Trichomonas vaginalis is the most common curable sexually transmitted infection worldwide. T vaginalis infections in women can range from asymptomatic to acute inflammatory vaginitis. In men, this infection is typically asymptomatic but is increasingly being recognised as a cause of non-gonococcal urethritis. Diagnosis of T vaginalis has traditionally been made by direct microscopic examination of a wet mount of vaginal fluid or through the use of culture. The recent commercial availability of nucleic acid amplification tests for the detection of T vaginalis has seen these replace culture as the gold standard for diagnosis. Nitroimidazoles (ie, metronidazole and tinidazole) are the mainstay of therapy. In the case of treatment failure due to drug resistance or in the case of a severe nitroimidazole allergy, alternative intravaginal therapies exist, although their effectiveness has not been evaluated systematically. Novel systemic agents other than nitroimidazoles for the treatment of T vaginalis are needed, and efforts to promote and support antimicrobial drug development in this setting are necessary.

show abstract

mentioning

confidence: 99%

The clinical spectrum ofTrichomonas vaginalisinfection and challenges to management

Muzny

Schwebke

2013

Sex Transm Infect

View full text Add to dashboard Cite

show abstract

“…Patients with suspected resistant T. vaginalis can be treated with longer courses of metronidazole or a trial of tinidazole, or referred to CDC experts for consultation [45]. There is a recent report [46] of recalcitrant trichomoniasis that responded to vaginal acidification using boric acid tablets for 6-20 weeks.…”

Section: Response To Treatmentmentioning

confidence: 99%

Trichomoniasis in teens: an update

Huppert

2009

Current Opinion in Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

“…Intravaginal boric acid has been used in patients with TV infection who are either unable to take first-line medication due to severe nitroimidazole allergy 4 or are resistant to standard treatment. 5 In these cases, extended topical treatment was given for 1-2 months resulting in cure. Prolonged use of boric acid pessaries has been associated with a number of side effects including seizures, anaemia, hair loss and anorexia, 6 and following discussion with the patient was not deemed appropriate as the next line of treatment.…”

mentioning

confidence: 99%

Successful treatment of refractory Trichomonas vaginalis infection using intravenous metronidazole

et al. 2014

View full text Add to dashboard Cite

Trichomonas vaginalis is a sexually transmitted protozoan infection resulting in a vulvo-vaginitis and altered vaginal discharge in symptomatic women. Since its introduction in the 1960 s, metronidazole has been the first-line drug for trichomonal infection. Other nitroimidazoles, such as tinidazole, are used as alternative regimens with similar activity but at a greater expense. Treatment failure usually represents patient non-compliance or reinfection, although metronidazole resistance has previously been documented. Sensitivity testing is currently not available in the UK. Patients with disease unresponsive to first-line treatments pose a major challenge, as therapeutic options are limited. This case looks at a patient with refractory disease over an 18-month period, where intravenous infusion of metronidazole resulted in cure after multiple previous therapy failures. There is limited evidence to endorse the use of intravenous metronidazole, and this case report provides further support for its efficacy.

show abstract

Recalcitrant Trichomonas Vaginalis Infections Successfully Treated With Vaginal Acidification

Cited by 28 publications

References 25 publications

The clinical spectrum ofTrichomonas vaginalisinfection and challenges to management

The clinical spectrum ofTrichomonas vaginalisinfection and challenges to management

Trichomoniasis in teens: an update

Successful treatment of refractory Trichomonas vaginalis infection using intravenous metronidazole

Contact Info

Product

Resources

About