Trichomoniasis and its treatment.
Trichomonas vaginalis has long been recognized as a cause of infectious vaginitis in women. More recently, studies have demonstrated a significant burden of disease in men with urethritis or men at high risk for sexually transmitted diseases. There is increasing interest in this pathogen as more data accumulates linking it to HIV transmission and perinatal morbidity. New diagnostic methods have emerged that may increase sensitivity of diagnosis or improve point-of-care access to testing. Nitroimidazoles remain the mainstay of therapy. Metronidazole and tinidazole are highly effective as single-dose therapy. Unfortunately, despite the link between T. vaginalis infection and perinatal morbidity, nitroimidazole therapy during pregnancy remains controversial. Although metronidazole resistance is currently uncommon, pharmacological features and nitroimidazole resistance patterns suggest that tinidazole may be more effective in treating patients with metronidazole treatment failure. Alternatives to nitroimidazole therapy are few, and most have limited efficacy and significant toxicity.
Nanda
Neha
N
Department of Medicine, Oklahoma University Health Science Center, Oklahoma City, OK, USA.
Michel
Ross G
RG
Kurdgelashvili
George
G
Wendel
Karen A
KA
D000328:Adult; D000818:Animals; D000994:Antitrichomonal Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009017:Morbidity; D009593:Nitroimidazoles / Q000627:therapeutic use*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology; D014245:Trichomonas Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology; D014247:Trichomonas Vaginitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology; D014246:Trichomonas vaginalis / Q000187:drug effects*; D014526:Urethritis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology
D000994:Antitrichomonal Agents; D009593:Nitroimidazoles