Nonoxynol 9 as an additive therapy in metronidazole-resistant cases of vaginal trichomoniasis

ABSTRACT

The present study was conducted on 30 female patients with rnetronidazole resistant vaginal trichomoniasis to investigate the efficacy of nonoxynol 9 [N-9], a non hormonal contraceptive with spermicidal effect, as an additive therapy to metronidazole [MNZ]. Study population were randomly divided into 3 groups according to treatment regimen G.I patients received high dose MNZ [2g daily for 7 days] n = 10; G. II patients received [100mg N-9 vaginal suppository daily for 7 days] n = 10; G. III patients receiving conventional MNZ dose [1g daily for 7 days] plus [a 100mg N-9 suppository for 7 days] n = 10. Clinical and parasitological evaluation of cure was performed at return visits 1, 2, 4 and 6 weeks post treatment. Negative T. vaginalis vaginal smears were ensured by direct microscopic visualization and In Pouch TV culture technique. Most of the patients were in the 30-39 years age group [60%] and burning was the most frequent symptom [96.67%]. The cure rates were 70%, 40% and 90% for Gs I, II and III respectively, while adverse effects of treatment were recorded most frequently by patients of G.I. So, MNZ resistant trichomoniasis incidence seems to be on the rise. Topical therapy alone has a low cure rate while combined oral conventional doses of MNZ and intravaginal nonoxynol 9 treatment appears to be a good clinical trial with fairly good cure rate thus, avoiding the adverse side effects of high doses MNZ therapy and T. vaginalis health hazards potentiality