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Re: Resistant Trich? From: Griffiths Malcolm (Malcolm.Griffiths@ldh-tr.anglox.nhs.uk) Tue Apr 24 05:33:39 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. Rupak Ranjan Roy: "Re: PPROM" Previous message: Griffiths Malcolm: "Re: PPROM" Maybe in reply to: Joanne Bulley, MD: "Resistant Trich?" Next in thread: Richard Chudacoff, MD: "Re: Resistant Trich?" Occasionally patients either have a resistant Trich or they have a problem with absorption. Options are to give bigger and bigger doses (until side effects reached or to treat vaginally. There is a topical version of metronidazole, which has been used in treatment of Vulval and Perianal Crohns (I seem to recall), but it's not easy to get hold of. I've simply used the rectal suppositories vaginally. Off-licence of course! -----Original Message----- From: jbulley@cheshire.net [mailto:jbulley@cheshire.net] Sent: 24 April 2001 04:28 To: Multiple recipients of list OB-GYN-L 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 ********************************************************************** This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the system manager. This footnote also confirms that this email message has been swept by MIMEsweeper for the presence of computer viruses. ********************************************************************** Next message: Dr. Rupak Ranjan Roy: "Re: PPROM" Previous message: Griffiths Malcolm: "Re: PPROM" Maybe in reply to: Joanne Bulley, MD: "Resistant Trich?" Next in thread: Richard Chudacoff, MD: "Re: Resistant Trich?"

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