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GYN: metronidazole-resistant trichFrom: art fougner, md (evsono@pipeline.com)Tue Apr 14 07:34:56 1998
re: a thread from a short while ago, this just in - Paromomycin Cream Effective For Difficult-to-Treat Trichomoniasis WESTPORT, Apr 14 (Reuters) - Paromomycin cream is an effective alternative medication for some cases of difficult-to-treat trichomoniasis, according to the results of a retrospective study. Dr. Paul Nyirjesy, of Temple University in Philadelphia, Pennsylvania, and colleagues there and at Wayne State University, Detroit, Michigan, reviewed the records of nine patients, five of whom were allergic to metronidazole and four of whom had metronidazole-resistant infections. The patients had been treated with 250 mg of paromomycin per 4-gram applicator of hydrophilic cream, nightly for 2 weeks. "Immediately after completion of paromomycin treatment, saline smears from all patients except for one were negative for Trichomonas," Dr. Nyirjesy's team reports in the April issue of Clinical Infectious Diseases. "However, cultures for two patients were positive and a fourth patient's infection relapsed 2 weeks after treatment. Of these four patients for whom treatment failed, two were retreated with a 3-week course of paromomycin cream; one of these patients was cured." The researchers note that the latter patient responded to "...a combination of paromomycin cream for 5 days and 500 mg of oral tinidazole four times daily for 14 days," which was prescribed "...somewhat out of desperation..." after the patient failed to respond to tinidazole monotherapy and to paromomycin monotherapy. Three patients developed vaginal ulcerations that resolved spontaneously once treatment was completed, Dr. Nyirjesy's group reports. "Although these effects were self-limited and observed only at one clinic, further experience with this medication is necessary to obtain more accurate information with regard to efficacy and safety." Clin Infect Dis 1998;26:986-988. -Westport Newsroom 203 319 2700 thought this would be of interest. art
-- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com
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