title: Treatment failure of vaginal trichomoniasis in clinical practice.
abstract: We have conducted a retrospective study of treatment failure of Trichomonas vaginalis (TV) infection in a busy, urban genitourinary medicine clinic in Birmingham, UK, between 1998 and 2002. The prevalence of non-response to standard doses of metronidazole without any history of reinfection or nonadherence was 1.7% (28/1603) overall, and has significantly increased from 0.38% in 1999 to 3.5% in 2002 (P = 0.001, chi2 test). There were no associated demographic factors. The majority of patients (53% or 15/28) responded to either a repeat of standard (10/26) or higher oral dose (5/7) of metronidazole. A standardized treatment algorithm using a high dose of metronidazole may be useful in the absence of any new, efficacious non-imidazole-based TV therapy in the clinical management of persistent TV infection.
authors.affiliation: Department of Genito-Urinary Medicine, Whittall Street Clinic, Whittall Street, Birmingham B4 6DH, UK. sat.das@ntlworld.com
authors.forename: Satyajit
authors.initials: S
authors.lastname: Das
authors.forename: Mia
authors.initials: M
authors.lastname: Huengsberg
authors.forename: Mohsen
authors.initials: M
authors.lastname: Shahmanesh
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000554:Ambulatory Care Facilities; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D019233:Retreatment; D012189:Retrospective Studies; D017211:Treatment Failure; D014247:Trichomonas Vaginitis / Q000188:drug therapy*; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents; D000981:Antiprotozoal Agents; D008795:Metronidazole; D000658:Amoxicillin