Sexually Transmitted Diseases

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Sexually Transmitted Diseases:
Original Article

Successful Treatment of Four Patients With Recalcitrant Vaginal Trichomoniasis With a Combination of Zinc Sulfate Douche and Metronidazole Therapy

HOUANG, ELIZABETH T. FRCPath*; AHMET, ZERIN BSc, MSc*; LAWRENCE, ADAM G. MBChB

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Abstract

Background and Objectives:: There is no certain cure available for patients suffering from recalcitrant trichomoniasis. Zinc sulfate is reported to have antitrichomonal properties. We report our experience in treating four patients empirically with a combination of zinc sulfate douche and metronidazole.

Study Design:: A retrospective case analysis. Patients who presented to the tertiary referral clinic with chronic recurrent trichomoniasis without evidence of reinfection were treated empirically with a combination of zinc sulfate douching (1%) followed by a metronidazole 500 mg suppository per vaginale twice daily and 200 to 400 mg three times a day orally. The douching and suppository were used prophylactically for 3 nights after menstruation for some months.

Results:: Four patients who had a history of 4 months to 4 years of culture‐positive symptomatic trichomoniasis and received a variety of therapies before referral were treated successfully. At the review 2 to 5 months after therapy, all had remained asymptomatic and the results of clinical and laboratory examinations were normal.

Conclusions:: The exact role of zinc sulfate douching in the successful outcome is not certain, but the combination therapy requires only a moderate dose of metronidazole (1.6–2.2 g/day), avoiding the side effects of larger doses. The combination therapy therefore merits further evaluation.

© Copyright 1997 American Sexually Transmitted Diseases Association

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