Trichomonas vaginalis: treatment and resistance to nitroimidazoles
Vázquez, F.; José García, M.; Pérez, F.; Palacio, V.
Enfermedades Infecciosas Y Microbiologia Clinica 19(3): 114-124
2001
ISSN/ISBN: 0213-005X PMID: 11333589 Document Number: 527696
This review examines the mode of action of metronidazole, the epidemiology of drug resistance in Trichomonas vaginalis, and new therapeutic options for the control of trichomoniasis. The different types of nitroimidazoles are listed and described. Resistance mechanisms to metronidazole are considered, with reference to the role of hydrogenosomes, factors contributing to treatment failure (lack of compliance, intrinsic parasitic factors, etc.) and in vitro studies. The epidemiology of metronidazole resistance since the 1980s, oral drug doses and alternative applications (topical, prolonged treatment, intravenous), and drug therapy in different situations (pregnancy, HIV infections, small children) are discussed. Alternative therapeutic options include cotrimoxazole, furazolidone, paromomycin, zinc salts, spermicides (nonoxinol-9), vaccination with inactivated Lactobacillus acidophilus, suppression of oestrogen treatment, sulfanilamide suppositories, and nitazoxanide (a new broad spectrum antiparasiticide).