title: Difficult-to-treat trichomoniasis: results with paromomycin cream.
abstract: Vaginal trichomoniasis poses a difficult therapeutic challenge when metronidazole is ineffective or contraindicated. We conducted a retrospective study of 6.25% paromomycin cream in the treatment of nine women referred with cases of vaginal trichomoniasis where metronidazole resistance or allergy was present. Results obtained immediately and 1 month after treatment were reviewed. The median age of the patients was 46 years; four women were nulliparous. The median symptom duration was 1 year. Five women were allergic to metronidazole. In four cases, resistance to high doses of metronidazole was demonstrated. Smears or cultures were positive immediately after treatment for three patients; a fourth relapsed 2 weeks later. Of these patients for whom treatment failed, one was cured with a 3-week course of paromomycin cream, and another was successfully treated with paromomycin cream and oral tinidazole. Three patients developed vaginal ulcerations that resolved spontaneously. Adverse effects may be a result of local formulation. Paromomycin cream was useful for treatment of cases of trichomonas infection where metronidazole resistance or allergy was encountered.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
authors.forename: P
authors.initials: P
authors.lastname: Nyirjesy
authors.forename: J D
authors.initials: JD
authors.lastname: Sobel
authors.forename: M V
authors.initials: MV
authors.lastname: Weitz
authors.forename: D J
authors.initials: DJ
authors.lastname: Leaman
authors.forename: S P
authors.initials: SP
authors.lastname: Gelone
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000994:Antitrichomonal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010303:Paromomycin / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014245:Trichomonas Infections / Q000188:drug therapy*; D014623:Vaginal Diseases
chemical_list: D000900:Anti-Bacterial Agents; D000994:Antitrichomonal Agents; D010303:Paromomycin