Management of trichomonas vaginalis in women with suspected metronidazole hypersensitivity.
OBJECTIVE
Standard treatment for Trichomonas vaginalis is metronidazole or tinidazole. Hypersensitivity to these drugs has been documented but is poorly understood. Desensitization is an option described in limited reports of women with hypersensitivity to nitroimidazoles. The purpose of this analysis is to improve documentation of management for trichomonas infections among women with metronidazole hypersensitivity.


METHODS
Clinicians who consulted Centers for Disease Control and Prevention concerning patients with suspected hypersensitivity to metronidazole were provided with treatment options and asked to report outcomes.


RESULTS
From September 2003-September 2006, complete information was obtained for 59 women. The most common reactions were urticaria (47%) and facial edema (11%). Fifteen of these women (25.4%) were treated with metronidazole desensitization and all had eradication of their infection. Seventeen women (28.8%) were treated with alternative intravaginal drugs, which were less successful; 5 of 17 infections (29.4%) were eradicated.


CONCLUSIONS
Metronidazole desensitization was effective in the management of women with nitroimidazole hypersensitivity.
Helms
Donna J
DJ
Division of STD Prevention, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA. dhelms@cdc.gov
Mosure
Debra J
DJ
Secor
W Evan
WE
Workowski
Kimberly A
KA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000981:Antiprotozoal Agents / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000276:immunology; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D008875:Middle Aged; D014247:Trichomonas Vaginitis / Q000188:drug therapy*; D014246:Trichomonas vaginalis / Q000187:drug effects*
D000981:Antiprotozoal Agents; D008795:Metronidazole