Details:

Alternative Title:
Sex Transm Dis
Personal Author:
Augostini, Peter ; Bradley, Erin L. P. ; Raphael, Brian H. ; Secor, W. Evan
Augostini, Peter ; Bradley, Erin L. P. ; Raphael, Brian H. ; Secor, W. Evan Less -
Description:
Background:

The only drugs approved by the U.S. Food and Drug Administration for oral treatment of trichomoniasis belong to the 5-nitroimidazole group. Most individuals infected with Trichomonas vaginalis can be cured with a standard treatment of metronidazole or tinidazole, but it is estimated that more than 159,000 people fail treatment each year. Although a minimal lethal concentration (MLC) corresponding to treatment failure has been reported for metronidazole, the MLC for tinidazole associated with treatment failure has not been determined. We conducted a study using T. vaginalis isolates from women with reported treatment success or failure to determine these values.

Methods:

We measured MLCs of 47 isolates obtained from women who had failed metronidazole treatment, 33 isolates from women who had failed tinidazole treatment, and 48 isolates from women successfully cured with metronidazole. The cutoff was calculated as the 95th percentile of MLCs of susceptible isolates for each drug.

Results:

Our data confirmed the MLC previously associated with metronidazole treatment failure is ≥ 50 μg/ml and identified the MLC associated with tinidazole treatment failure as ≥ 6.3 μg/ml. For metronidazole, the agreement between laboratory result and treatment outcome was 93.7%, for tinidazole this agreement was 88.9%.

Conclusions:

The T. vaginalis susceptibility assay is useful for determining whether 5-nitroimidazole treatment failure in persons with trichomoniasis can be attributed to drug resistance. These results are useful for establishing interpretive guidance of test results and MLC levels can help guide appropriate patient treatment.


Subjects:
[+]
Article Drug Resistance Female Humans In Vitro Techniques Metronidazole Pharmaceutical Preparations Resistance Tinidazole Treatment Failure Trichomonas Infections Trichomonas Vaginalis Trichomonas Vaginitis Trichomoniasis
Source:
Sex Transm Dis. 50(6):370-373
Pubmed ID:
36849257
Pubmed Central ID:
PMC10175203
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:cfa3a6e78ca3ff33ccf85d967732f3b0d9d4086979529c4f238aabd3048bd03c
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