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Re: resistant TrichomoniasisFrom: Braun, R. Daniel (rbraun@iupui.edu)Thu Aug 31 06:56:03 2000
Have her take it 15 minutes after a meal. Tell her that either she keeps it down or puts up with the trich. There are no other options. Dan R. Daniel Braun, MD FACOG Clinical Professor Department of Obstetrics and Gynecology Indiana U. School of Medicine Indianapolis, IN 46202 OBGYN.net International Representative for United States Certified AllExperts Expert Check out my bio/ratings page! http://www.allexperts.com/displayExpert.asp?Expert=1236 -----Original Message----- From: Richard Chudacoff, MD [mailto:rchudacoff@mylinuxisp.com] Sent: Wednesday, August 30, 2000 5:11 PM To: Multiple recipients of list OB-GYN-L Subject: Re: resistant Trichomoniasis Okay Bob, I mean Joe. Although, Sanford does list the alternative of vaginal gel in pregnancy. Still, since she cannot take MTDZ orally, and it doesn't work vaginally, what do you recommend? Rick -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of DoctorJoe@aol.com Sent: Wednesday, August 30, 2000 5:04 PM To: Multiple recipients of list OB-GYN-L Subject: Re: resistant Trichomoniasis In a message dated 8/30/00 2:37:41 PM, rchudacoff@mylinuxisp.com writes: << I have 22 yo G7 P1 (new patient, no old records, swears these are all spontaneous Abs) who presented at her new OB visit with Trichomoniasis. I treated her with oral Metronidazole, which she could not tolerate (GI upset). I then treated her with Metrogel for 7 days, and she returned with a positive test of cure. I repeated the gel for 14 day, and again she is positive on wet mount. Her husband has been on an oil rig for a couple of months and she states she has not had intercourse with anybody. What is interesting is the Trichamonads are now more rounded and slightly larger, but still one can see the flagellum beating. What do you use for resistant Trichomoniasis? Do you think this could be something else? >> Well, technically speaking, if she didn't take a complete oral course, then she's not "resistant," she's been insufficiently treated. Vaginal gel is not effective against trich (only gets those in the immediate vicinity, not in the bladder, etc, etc.). What she NEEDS is a week course of oral metronidazole, although that seems to be a problem in your patient... Joe P.
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