Experience of successful treatment of patients with metronidazole-resistant Trichomonas vaginalis with zinc sulfate: A case series

Taiwan J Obstet Gynecol. 2015 Oct;54(5):617-20. doi: 10.1016/j.tjog.2015.08.018.

Abstract

Objective: There are no universally successful guidelines for the treatment of metronidazole-resistant vaginal trichomoniasis. This is distressing for patients and frustrating for physicians. We therefore decided to evaluate whether zinc sulfate douche is effective in treating vaginal trichomoniasis, because the compound is a natural antimicrobial chemical defense in humans.

Case reports: In our retrospective case review, eight cases of metronidazole-resistant trichomoniasis were treated with 1% zinc sulfate douche with or without tinidazole between 2005 and 2012. Except for one patient who was pregnant, seven patients were successfully treated and were negative for microscopic findings with no clinical symptoms at follow up.

Conclusion: Although the exact role of zinc sulfate in metronidazole-resistant trichomoniasis is not clear, our patients experienced a therapeutic effect with zinc sulfate douche treatment. We therefore recommend zinc sulfate douche as an option for the treatment of metronidazole-resistant vaginal trichomoniasis.

Keywords: Trichomonas vaginalis; metronidazole resistance; vaginal trichomoniasis; zinc sulfate.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Antiprotozoal Agents / pharmacology
  • Astringents / administration & dosage
  • Drug Resistance / drug effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Metronidazole / pharmacology*
  • Pregnancy
  • Pregnancy Complications, Parasitic / drug therapy*
  • Pregnancy Complications, Parasitic / parasitology
  • Trichomonas Vaginitis / drug therapy*
  • Trichomonas Vaginitis / parasitology
  • Trichomonas vaginalis / isolation & purification*
  • Vaginal Douching / methods*
  • Zinc Sulfate / administration & dosage*

Substances

  • Antiprotozoal Agents
  • Astringents
  • Metronidazole
  • Zinc Sulfate