Management of Trichomonas vaginalis in women with suspected metronidazole hypersensitivity
Presented at the 44th Annual Meeting of the Infectious Diseases Society of America, Toronto, ON, Canada, Oct. 12-15, 2006.
Received 25 May 2007; received in revised form 10 August 2007; accepted 11 October 2007. published online 28 January 2008.
Background/Objective
Standard treatment for Trichomonas vaginalis is metronidazole or tinidazole. Hypersensitivity to these drugs has been documented but is poorly understood. Desensitization is an option described in limited reports of women with hypersensitivity to nitroimidazoles. The purpose of this analysis is to improve documentation of management for trichomonas infections among women with metronidazole hypersensitivity.
Study Design
Clinicians who consulted Centers for Disease Control and Prevention concerning patients with suspected hypersensitivity to metronidazole were provided with treatment options and asked to report outcomes.
Results
From September 2003-September 2006, complete information was obtained for 59 women. The most common reactions were urticaria (47%) and facial edema (11%). Fifteen of these women (25.4%) were treated with metronidazole desensitization and all had eradication of their infection. Seventeen women (28.8%) were treated with alternative intravaginal drugs, which were less successful; 5 of 17 infections (29.4%) were eradicated.
Conclusion
Metronidazole desensitization was effective in the management of women with nitroimidazole hypersensitivity.
Reprints: Donna Helms, DSTDP/CCID/CDC, 1600 Clifton Rd, Mailstop E-02, Atlanta, GA 30329.
This study was supported in part by appointment of D.J.H. to the Research Participation Program of the Centers for Disease Control and Prevention, administered by the Oak Ridge Institute for Science and Education.
The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Cite this article as: Helms DJ, Mosure DJ, Secor WE, et al. Management of Trichomonas vaginalis in women with suspected metronidazole hypersensitivity. Am J Obstet Gynecol 2008;198:370.e1-370.e7.
ABSTRACT
Management of Trichomonas vaginalis in women with suspected metronidazole hypersensitivity