Single-dose metronidazole still first choice for most cases of trichomoniasis

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Last Updated: 2001-07-20 17:22:49 EDT (Reuters Health)

WESTPORT, CT (Reuters Health) – While low-level resistance to metronidazole in Trichomonas vaginalis is prevalent throughout the US, high-level resistance to this compound is rare, according to a study conducted in Atlanta, Georgia.

The findings "confirm, in the absence of reinfection, the continuing clinical effectiveness of single-dose metronidazole for the large majority of trichomoniasis cases," study director, Dr. George Schmid, of the Centers for Disease Control and Prevention, Atlanta, and a multicenter team conclude in the June issue of The Journal of Reproductive Medicine.

The investigators determined that 82 of 911 women attending a gynecology clinic were infected with T. vaginalis. Only two of the 82 isolates (2.4%) had low-level in vitro resistance to metronidazole, and Dr. Schmid's group says this finding is similar to the results of a previous US report that estimated the prevalence of low-level resistance to be 5%. None of the isolates had medium- or high-level resistance to the drug.

All patients were treated with single-dose metronidazole at the clinic. Of the 26 who returned for followup examinations (including one of the women infected with a resistant isolate), all were cured.

"Other American studies found lessened rates of success," the investigators warn. "Clinicians should not assume that patients treated with recommended doses of metronidazole are 'automatically' cured."

J Reprod Med 2001;46:545-549.

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