מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – High-dose tinidazole is highly effective and well tolerated in women with metronidazole-resistant vaginal trichomoniasis, even those who fail treatment with high-dose metronidazole.
Dr. J. D. Sobel, of Detroit Medical Center and Wayne State University School of Medicine, and a multicenter team examined the efficacy of high-dose tinidazole in 24 women with metronidazole-resistant vaginal trichomoniasis, including "15 cases with increased in vitro minimal lethal concentration values of metronidazole."
Treatment consisted of either oral tinidazole, 500 mg q.i.d., plus intravaginal tinidazole, 500 mg b.i.d., for 14 days, or oral tinidazole, 1 g t.i.d, plus intravaginal tinidazole, 500 mg t.i.d., for 14 days.
After 14 days, 22 of 24 patients were cured, the team reports in the October 15th issue of Clinical Infectious Diseases. Moreover, not one patient needed to discontinue treatment because of side effects, Dr. Sobel told Reuters Health. He added that it is somewhat surprising that tinidazole remains effective against metronidazole-resistant trichomoniasis, since the two drugs are in the same antimicrobial class.
In the journal, the researchers highlight the importance of cooperating with the Centers for Disease Control and Prevention to monitor the prevalence of metronidazole-resistant trichomoniasis. US physicians treating patients who fail to respond to metronidazole can arrange for antimicrobial susceptibility testing by calling 404-639-8363.
Tinidazole is not approved for use in the US because the manufacturer never chose to submit an application, Dr. Sobel said. It is widely used in other parts of the world.
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