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Clinical Microbiology Reviews, October 2004, p. 783-793, Vol. 17, No. 4
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.4.783-793.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Treatment of Infections Caused by Metronidazole-Resistant Trichomonas vaginalis

Sarah L. Cudmore, Kiera L. Delgaty, Shannon F. Hayward-McClelland, Dino P. Petrin, and Gary E. Garber*

Department of Biochemistry, Microbiology, and Immunology and Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada

Infections with the sexually transmitted protozoan Trichomonas vaginalis are usually treated with metronidazole, a 5-nitroimidazole drug derived from the antibiotic azomycin. Metronidazole treatment is generally efficient in eliminating T. vaginalis infection and has a low risk of serious side effects. However, studies have shown that at least 5% of clinical cases of trichomoniasis are caused by parasites resistant to the drug. The lack of approved alternative therapies for T. vaginalis treatment means that higher and sometimes toxic doses of metronidazole are the only option for patients with resistant disease. Clearly, studies of the treatment and prevention of refractory trichomoniasis are essential. This review describes the mechanisms of metronidazole resistance in T. vaginalis and provides a summary of trichomonicidal and vaccine candidate drugs.

* Corresponding author. Mailing address: Division of Infectious Diseases, Ottawa Hospital, General Campus, 501 Smyth Rd., Ottawa, ON, Canada K1H 8L6. Phone: (613) 737-8173. Fax: (613) 737-8099. E-mail: ggarber{at}ohri.ca.

Clinical Microbiology Reviews, October 2004, p. 783-793, Vol. 17, No. 4
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.4.783-793.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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