Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
STDs (Expert Forum)
Resistant trichomoniasis
Answered by
University of Washington
Seattle - WA
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.
IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
|
Resistant trichomoniasis
by lisamush1, Feb 24, 2005 12:00AM
Hello, Dr. Handsfield-
I don't know whether you are comfortable with specific patient questions, but I'm just looking for some guidance as to what other treatments to try, or where else i can go to find answers...
I'm a physician assistant in family planning. I have a woman patient with resistant trichomoniasis. She has been treated with:
1)Flagyl 500 mg PO bid x 7 days
2)Tindamax 500 mg 4 PO stat
3)Tindamax 500 mg 4 PO stat followed by Flagyl 500 mg PO bid x 14 days along with zinc sulfate douche 1% qd x 14 days
4) Vermox 100 mg PO bid x 3 days
5) Flagyl 500 mg 2 PO tid x 14 days along with MetroGel Vaginal 1 applicator qHS x 14 days
None have been effective. The last treatment regimen was the most effective, but not completely. The patient has not been sexually active since 8/04.
I have been attempting to search the medical literature and there does not seem to be a lot out there on any other alternatives. I've seen reference to paramomycin and to Vagisec suppositories, but apparently both have been removed from the market. I've read reference to disulfiram, furazolidone, anisomycin and rifabutin, but nothing about dose or length of treatment. A pharmacist told me he found reference at one time to aminoglycosides being effective, but I have not been able to find any reference to these. I've also read a case study where nonoxynol-9 worked, and have considered trying this.
Do you have any recommendations as to what to try next or where to look for additional/more specific suggestions? I would truly appreciate it. Thank you!
Lisa S, PA-C
I don't know whether you are comfortable with specific patient questions, but I'm just looking for some guidance as to what other treatments to try, or where else i can go to find answers...
I'm a physician assistant in family planning. I have a woman patient with resistant trichomoniasis. She has been treated with:
1)Flagyl 500 mg PO bid x 7 days
2)Tindamax 500 mg 4 PO stat
3)Tindamax 500 mg 4 PO stat followed by Flagyl 500 mg PO bid x 14 days along with zinc sulfate douche 1% qd x 14 days
4) Vermox 100 mg PO bid x 3 days
5) Flagyl 500 mg 2 PO tid x 14 days along with MetroGel Vaginal 1 applicator qHS x 14 days
None have been effective. The last treatment regimen was the most effective, but not completely. The patient has not been sexually active since 8/04.
I have been attempting to search the medical literature and there does not seem to be a lot out there on any other alternatives. I've seen reference to paramomycin and to Vagisec suppositories, but apparently both have been removed from the market. I've read reference to disulfiram, furazolidone, anisomycin and rifabutin, but nothing about dose or length of treatment. A pharmacist told me he found reference at one time to aminoglycosides being effective, but I have not been able to find any reference to these. I've also read a case study where nonoxynol-9 worked, and have considered trying this.
Do you have any recommendations as to what to try next or where to look for additional/more specific suggestions? I would truly appreciate it. Thank you!
Lisa S, PA-C
Doctor's Answer
by H. Hunter Handsfield, M.D., Feb 24, 2005 12:00AM
, Feb 24, 2005 12:00AM
Wow--not many cases will fail to respond to that barrage. The next step may be parenteral (IV) therapy with metronidazole. In theory, oral metronidazole gives blood levels about the same as IV, but some success has been reported with high dose IV therapy. Fortunately, IV therapy usually no longer requires hospitalization for the entire treatment period. But before proceding, I suggest getting a formal consult with an infectious disease-oriented gynecologist. Such persons normally can be found in major medical centers.
Good luck-- HHH, MD
Good luck-- HHH, MD
Communities
Ask a Doctor Forums
Tools and Applications
Personal Information
Medical Information
Doctors and Partners
Sample douches:
One teaspoon of Melaleuca alternifolia (tea tree) oil in two cups of water.
two week treatment regime using Betadine preparations. These can be purchased pre diluted or one can be made from 1/2 tablespoon of a standard solution (povidone-iodine 10%) to 2 cups of water.
An ethanol extract of propolis (150mcg per ml) has been shown to have a 100% lethal effect in tests on Trichomonas vaginalis after 24 hours of contact. This extract has also been shown to decrease the inflammation associated with trichomonal vaginitis.
Essential oils have well-demonstrated antimicrobial action. Many possess strong antitrichomonal properties. Mentha piperita (peppermint) and Lavandula angustifolia (lavender) had the fastest killing action.