Metronidazole-resistant trichomoniasis and successful therapy following high dosage
Weihe, J.; Metelmann, C.; Borner, K.; Meingassner, J.; Orfanos, C.E.
Der Hautarzt; Zeitschrift für Dermatologie Venerologie und verwandte Gebiete 39(4): 237-239
1988
ISSN/ISBN: 0017-8470 PMID: 3384665 Document Number: 308270
A patient is reported who suffered for several months from a Trichomonas vaginalis infection that was resistant to the usual low-dose treatment with 5-nitro-imidazole derivatives. Following various ineffective therapeutic trials, the agent was isolated in order to determine its sensitivity to 5-nitro-imidazole. The resistance of the isolate to metronidazole was confirmed in vitro and in an animal experiment; the patient was therefore treated with high daily doses of metronidazole, 3 x 750 mg orally as well as 2 x 100 mg topically for 14 days. Substitution therapy with zinc was administered in order to normalize the patient's relatively low zinc serum levels. These measures finally led to a clinical cure and elimination of the pathogenic agent. This is the first confirmed case of a metronidazole-resistant Trichomonas vaginalis infection reported in the Federal Republic of Germany.