Tinidazole for the treatment of vaginal infections.
Tinidazole has been used for vaginal infection worldwide but not in the US for > 40 years. Recently, tinidazole has been re-introduced and approved by the FDA for trichomoniasis and restudied as an alternative to metronidazole for bacterial vaginosis. In vitro antimicrobial activity and pharmacokinetics studies indicate that tinidazole has minor but possibly relevant antimicrobial as well as pharmacokinetic advantages when compared directly with metronidazole. Clinical comparison has been infrequent although the limited head-to-head studies indicate minimal therapeutic advantage with tinidazole. Perhaps the more relevant differences relate to the enhanced tolerance and reduced toxicity of tinidazole. Ongoing, as yet incomplete, studies directly comparing the clinical efficacy of metronidazole and tinidazole for bacterial vaginosis should clarify the status of tinidazole; however, cure rates are unlikely to be significantly different. Although uncommon, high-level trichomonal metronidazole resistance can be reliably cured by using tinidazole, which is an invaluable advantage.
Nailor
Michael D
MD
Detroit Receiving Hospital, Department of Pharmacy, Detroit, MI, USA.
Sobel
Jack D
JD
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000994:Antitrichomonal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004347:Drug Interactions; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D021261:Parasitic Sensitivity Tests; D014011:Tinidazole / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome; D014247:Trichomonas Vaginitis / Q000188:drug therapy*; D016585:Vaginosis, Bacterial / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000994:Antitrichomonal Agents; D014011:Tinidazole; D008795:Metronidazole