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Re: Resistant Trich? From: Rafael Haciski MD (haciski@earthlink.net) Tue Apr 24 00:22:59 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Rafael Haciski MD: "Re: The end of our specialty" Previous message: Rafael Haciski MD: "Re: DHEA-S refs./PCOS defn." In reply to: Joanne Bulley, MD: "Resistant Trich?" Next in thread: Joanne Bulley: "Re: sistant Trich?" Reply: Joanne Bulley: "Re: sistant Trich?" I have had several of these "resistant" infections in the past - all resolved with persistent treatment. Suggested approach: ...diagnose and treat per usual ...no intercourse in interim ...see patient at conclusion of treatment At that time I will see trich again, although in much lesser numbers. If that is the case then proceed to ...Metronidazole douche or vaginal gel preparations ...longer course of oral Metronidazole Each of my 2 or three cases resolved with this approach. Based on these few numbers, it is my feeling that these are most likely partial/incomplete treatments, and not resistant organisms, as they have responded to longer regimen. -- Rafael Haciski, MD FACOG Gynecology & Infertility Assoc. Baltimore MD http://www.ivf-md.com > From: jbulley@cheshire.net (Joanne Bulley, MD) > Reply-To: ob-gyn-l@obgyn.net > Date: Mon, 23 Apr 2001 22:27:53 -0500 > To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com> > Subject: Resistant Trich? > > I have a 45-ish patient who was treated for trichomonas in late February > - she & spouse - with 2gm metronidazole po. Back into office in early > April - no sex (husband seeing uro for a problem) still has trich - 2 gm > metronidazole to each given again. > > Back in office today - still has trich.... > > The MMWR says to give metronidazole 500 mg twice daily for 7 days if the > one time dose doesn't work - then 2 gm daily x 3-5 days if that doesn't > work - and if THAT doesn't work to call the CDC! > > the patient asked if we could get her insurance company to pay for her > to go to Atlanta to the CDC rather than sending a specimen! > > Any experience or suggestions WELCOME!!! > > I think I jinxed myself - I had recently said I hadn't seen trich in so > long on a wet mount that I didn't know if I would recognize it!!!! > > Thanks > > Joanne > > -- > Joanne Bulley, MD > Keene, NH, USA Next message: Rafael Haciski MD: "Re: The end of our specialty" Previous message: Rafael Haciski MD: "Re: DHEA-S refs./PCOS defn." In reply to: Joanne Bulley, MD: "Resistant Trich?" Next in thread: Joanne Bulley: "Re: sistant Trich?" Reply: Joanne Bulley: "Re: sistant Trich?"

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