Management of Resistant Trichomoniasis
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Purpose of Review
Trichomonas vaginalis is the most prevalent sexually transmitted parasite in the USA; resistant infection is emerging. New drug therapies and dosing regimens of standard therapies are being studied to treat resistant infection.
Diagnosis of trichomoniasis has become more sensitive, specific, and widely available with the advent of nucleic acid amplification tests (NAATs). Women with resistant trichomoniasis should be treated with high-dose regimens of metronidazole or tinidazole. Alternative treatment options have been described, and there has been some success particularly with high-dose tinidazole/intravaginal paromomycin cream combination, intravaginal boric acid, and intravaginal metronidazole/miconazole.
Resistant trichomoniasis is a growing public health concern with implications for long-term health consequences. More data are needed to further evaluate mechanisms by which resistance occurs as well as promising therapies for those affected.
KeywordsTrichomonas vaginalis Trichomoniasis Metronidazole Tinidazole Resistant trichomoniasis Metronidazole resistance
Compliance with Ethical Standards
Conflict of Interest
Dr. Alessio has no conflicts of interest to disclose.
Dr. Nyirjesy has received grants from Mycovia Pharmaceuticals; Curatek Pharmaceuticals; Scynexis, Inc.; and Hologic. He also serves as a consultant for Mycovia Pharmaceuticals; Lupin Pharmaceuticals; Hologic; Scynexis, Inc.; Daré Bioscience; Inc.; and BD.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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