American Journal of Obstetrics & Gynecology
Volume 198, Issue 4 , Pages 370.e1-370.e7, April 2008

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.

  • Donna J. Helms, MPH

      Affiliations

    • Division of STD Prevention, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
    • Corresponding Author InformationReprints: Donna Helms, DSTDP/CCID/CDC, 1600 Clifton Rd, Mailstop E-02, Atlanta, GA 30329.
    • ,
  • Debra J. Mosure, PhD

      Affiliations

    • Division of STD Prevention, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
    • ,
  • W. Evan Secor, PhD

      Affiliations

    • Division of Parasitic Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
    • ,
  • Kimberly A. Workowski, MD

      Affiliations

    • Division of STD Prevention, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
    • Emory University, Atlanta, GA.

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.

Key words: desensitization, hypersensitivity, metronidazole, tinidazole, trichomonas

 

 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.

PII: S0002-9378(07)02017-0

doi:10.1016/j.ajog.2007.10.795

American Journal of Obstetrics & Gynecology
Volume 198, Issue 4 , Pages 370.e1-370.e7, April 2008