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Metronidazole-Resistant Trichomoniasis

Beneficial Pharmacodynamic Relationship With High-Dose Oral Tinidazole and Vaginal Paromomycin Combination Therapy

Henien, Mira, BS; Nyirjesy, Paul, MD; Smith, Katharine, PhD, CRNP

Sexually Transmitted Diseases: January 2019 - Volume 46 - Issue 1 - p e1–e2
doi: 10.1097/OLQ.0000000000000903
Case Report

Metronidazole-resistant trichomoniasis is an uncommon condition that presents significant therapeutic challenges. Combination therapy with high-dose oral tinidazole and vaginal paromomycin cream has been uniformly successful. We present a case report of a patient who responded to combination therapy with high-dose oral tinidazole and intravaginal paromomycin.

Oral tinidazole and vaginal paromomycin work better in combination than separately for metronidazole-resistant trichomoniasis.

From the Department of Obstetrics and Gynecology, Drexel Vaginitis Center, Philadelphia, PA

Conflict of Interest and Source of Funding: M.H. and K.S. have no conflicts to declare. P.N. has served as a consultant for Lupin Pharmaceuticals, Mycovia Pharmaceuticals, Cidara Therapeutics, Scynexis, Inc. and Hologic, Inc. P.N. has been an investigator on studies funded by Scynexis, Inc. and Curatek Pharmaceuticals. This study received no external funding.

Correspondence: Mira Henien, BS, Department of Obstetrics and Gynecology, Drexel Vaginitis Center, 216 N Broad St, Philadelphia, PA 19102. E-mail:

Received for publication June 27, 2018, and accepted August 6, 2018.

© Copyright 2019 American Sexually Transmitted Diseases Association