Treatment of Urogenital Trichomoniasis in Patients with Hypersensitivity to 5-Nitroimidazole Drugs

5-Nitroimidazole compounds are the standard treatment for urogenital trichomoniasis. When a patient has confirmed hypersensitivity to this drug class, an entirely different therapeutic approach is needed.

Clinical scenario

This protocol is indicated for patients with urogenital trichomoniasis who have documented hypersensitivity to 5-nitroimidazole drugs, making the conventional first-choice agents contraindicated.

Treatment approach (partial overview — full regimen below)

Both systemic agents from outside the nitroimidazole class and locally acting intravaginal preparations have been studied as alternatives in this setting … complete regimen, sequencing, and dosing available in the full protocol.

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References

DOI: 10.1128/cmr.00109-16

Although the 5-nitroimidazole compounds are the most effective drugs for treating T. vaginalis infection, disulfiram and nithiamide (Fig. 2c and d) might represent alternatives for treating patients with hypersensitivity to 5-nitroimidazole drugs.

In a study conducted on nine patients infected with T. vaginalis, among whom four patients had strains that were metronidazole resistant and five patients were allergic to metronidazole, treatment with paromomycin cream (250 mg per 4-g applicator nightly) was achieved for 2 weeks, and six of nine women were cured.

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