title: [Metronidazole-resistant trichomoniasis and successful therapy following high dosage].
abstract: A patient is reported who suffered for several months from a Trichomonas vaginalis infection that was resistant to the usual low-dose treatment with 5-nitro-imidazole derivatives. Following various ineffective therapeutic trials, the agent was isolated in order to determine its sensitivity to 5-nitro-imidazole. The resistance of the isolate to metronidazole was confirmed in vitro and in an animal experiment; the patient was therefore treated with high daily doses of metronidazole, 3 x 750 mg orally as well as 2 x 100 mg topically for 14 days. Substitution therapy with zinc was administered in order to normalize the patient's relatively low zinc serum levels. These measures finally led to a clinical cure and elimination of the pathogenic agent. This is the first confirmed case of a metronidazole-resistant Trichomonas vaginalis infection reported in the Federal Republic of Germany.
authors.affiliation: Universitäts-Hautklinik und Poliklinik, Klinikum Steglitz der Freien Universität Berlin.
authors.forename: J
authors.initials: J
authors.lastname: Weihe
authors.forename: C
authors.initials: C
authors.lastname: Metelmann
authors.forename: K
authors.initials: K
authors.lastname: Borner
authors.forename: J
authors.initials: J
authors.lastname: Meingassner
authors.forename: C E
authors.initials: CE
authors.lastname: Orfanos
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage*; D014247:Trichomonas Vaginitis / Q000188:drug therapy*; D015032:Zinc / Q000172:deficiency
chemical_list: D008795:Metronidazole; D015032:Zinc
vernacular_title: Metronidazol-resistente Trichomoniasis und erfolgreiche Therapie nach hoher Dosierung.