title: Experience of successful treatment of patients with metronidazole-resistant Trichomonas vaginalis with zinc sulfate: A case series.
abstract: OBJECTIVE
  There are no universally successful guidelines for the treatment of metronidazole-resistant vaginal trichomoniasis. This is distressing for patients and frustrating for physicians. We therefore decided to evaluate whether zinc sulfate douche is effective in treating vaginal trichomoniasis, because the compound is a natural antimicrobial chemical defense in humans.
  
  
  METHODS
  In our retrospective case review, eight cases of metronidazole-resistant trichomoniasis were treated with 1% zinc sulfate douche with or without tinidazole between 2005 and 2012. Except for one patient who was pregnant, seven patients were successfully treated and were negative for microscopic findings with no clinical symptoms at follow up.
  
  
  CONCLUSIONS
  Although the exact role of zinc sulfate in metronidazole-resistant trichomoniasis is not clear, our patients experienced a therapeutic effect with zinc sulfate douche treatment. We therefore recommend zinc sulfate douche as an option for the treatment of metronidazole-resistant vaginal trichomoniasis.
authors.affiliation: Department of Obstetrics and Gynecology, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Paik Institute for Clinical Research, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea.
authors.forename: Jung Mi
authors.initials: JM
authors.lastname: Byun
authors.affiliation: Department of Obstetrics and Gynecology, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Paik Institute for Clinical Research, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea. Electronic address: hellojungmi@hanmail.net.
authors.forename: Dae Hoon
authors.initials: DH
authors.lastname: Jeong
authors.affiliation: Department of Obstetrics and Gynecology, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Paik Institute for Clinical Research, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea.
authors.forename: Young Nam
authors.initials: YN
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea.
authors.forename: Kyung Bok
authors.initials: KB
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea.
authors.forename: Moon Su
authors.initials: MS
authors.lastname: Sung
authors.affiliation: Department of Obstetrics and Gynecology, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Paik Institute for Clinical Research, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea.
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Kim
mesh_terms: D000328:Adult; D000818:Animals; D000981:Antiprotozoal Agents / Q000494:pharmacology; D001252:Astringents / Q000008:administration & dosage; D004351:Drug Resistance / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008795:Metronidazole / Q000494:pharmacology*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy* / Q000469:parasitology; D014247:Trichomonas Vaginitis / Q000188:drug therapy* / Q000469:parasitology; D014246:Trichomonas vaginalis / Q000302:isolation & purification*; D044364:Vaginal Douching / Q000379:methods*; D019287:Zinc Sulfate / Q000008:administration & dosage*
chemical_list: D000981:Antiprotozoal Agents; D001252:Astringents; D008795:Metronidazole; D019287:Zinc Sulfate
keywords: Trichomonas vaginalis; metronidazole resistance; vaginal trichomoniasis; zinc sulfate