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ATLANTA — Single-dose oral metronidazole—one of two recommended first-line treatment regimens for Trichomonas vaginalis—is less effective than a second-line, 7-day regimen of oral metronidazole in HIV-positive women, results from a randomized trial suggest.
Among 255 patients evaluated 6-12 days after treatment, those who received metronidazole 500 mg twice daily for 7 days were about half as likely as those receiving a single 2-g dose of metronidazole to have recurrent T. vaginalis infections (9% vs. 17%), according to the findings of a phase IV trial of medications that were already approved for this intended use.
The 7-day regimen also was associated with a lower rate of T. vaginalis positivity among 152 women who were assessed 3 months after treatment, with rates of 11% and 24%, respectively, said Dr. Patricia Kissinger, professor of epidemiology at Tulane University in New Orleans.
There was no difference in adherence between groups, with almost all patients (96%) reporting haven taken all of their metronidazole as instructed, and there were no significant differences in adverse event rates between the two arms.
Based on these findings, metronidazole administered as a single 2-g dose should no longer be recommended for the treatment of T. vaginalis among HIV-positive women, Dr. Kissinger said at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.
The National Institutes of Health funded the study. Dr. Kissinger reported having no relevant conflicts of interest.
ATLANTA — Single-dose oral metronidazole—one of two recommended first-line treatment regimens for Trichomonas vaginalis—is less effective than a second-line, 7-day regimen of oral metronidazole in HIV-positive women, results from a randomized trial suggest.
Among 255 patients evaluated 6-12 days after treatment, those who received metronidazole 500 mg twice daily for 7 days were about half as likely as those receiving a single 2-g dose of metronidazole to have recurrent T. vaginalis infections (9% vs. 17%), according to the findings of a phase IV trial of medications that were already approved for this intended use.
The 7-day regimen also was associated with a lower rate of T. vaginalis positivity among 152 women who were assessed 3 months after treatment, with rates of 11% and 24%, respectively, said Dr. Patricia Kissinger, professor of epidemiology at Tulane University in New Orleans.
There was no difference in adherence between groups, with almost all patients (96%) reporting haven taken all of their metronidazole as instructed, and there were no significant differences in adverse event rates between the two arms.
Based on these findings, metronidazole administered as a single 2-g dose should no longer be recommended for the treatment of T. vaginalis among HIV-positive women, Dr. Kissinger said at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.
The National Institutes of Health funded the study. Dr. Kissinger reported having no relevant conflicts of interest.
ATLANTA — Single-dose oral metronidazole—one of two recommended first-line treatment regimens for Trichomonas vaginalis—is less effective than a second-line, 7-day regimen of oral metronidazole in HIV-positive women, results from a randomized trial suggest.
Among 255 patients evaluated 6-12 days after treatment, those who received metronidazole 500 mg twice daily for 7 days were about half as likely as those receiving a single 2-g dose of metronidazole to have recurrent T. vaginalis infections (9% vs. 17%), according to the findings of a phase IV trial of medications that were already approved for this intended use.
The 7-day regimen also was associated with a lower rate of T. vaginalis positivity among 152 women who were assessed 3 months after treatment, with rates of 11% and 24%, respectively, said Dr. Patricia Kissinger, professor of epidemiology at Tulane University in New Orleans.
There was no difference in adherence between groups, with almost all patients (96%) reporting haven taken all of their metronidazole as instructed, and there were no significant differences in adverse event rates between the two arms.
Based on these findings, metronidazole administered as a single 2-g dose should no longer be recommended for the treatment of T. vaginalis among HIV-positive women, Dr. Kissinger said at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.
The National Institutes of Health funded the study. Dr. Kissinger reported having no relevant conflicts of interest.