SUCCESSFUL TREATMENT OF 4 PATIENTS WITH RECALCITRANT VAGINAL TRICHOMONIASIS WITH A COMBINATION OF ZINC-SULFATE DOUCHE AND METRONIDAZOLE THERAPY

Background and Objectives: There is no certain cure available for pati ents suffering from recalcitrant trichomoniasis. Zinc sulfate is repor ted to have antitrichomonal properties. We report our experience in tr eating four patients empirically with a combination of zinc sulfate do uche and metronidazole. Study Design: A retrospective case analysis, P atients who presented to the tertiary referral clinic with chronic rec urrent trichomoniasis without evidence of reinfection were treated emp irically with a combination of zinc sulfate douching (1%) followed by a metronidazole 500 mg suppository per vaginale twice daily and 200 to 400 mg three times a day orally. The douching and suppository were us ed prophylactically for 3 nights after menstruation for some months. R esults: Four patients who had a history of 4 months to 4 years of cult ure-positive symptomatic trichomoniasis and received a variety of ther apies before referral were treated successfully. At the review 2 to 5 months after therapy, all had remained asymptomatic and the results of clinical and laboratory examinations were normal. Conclusions: The ex act role of zinc sulfate douching in the successful outcome is not cer tain, but the combination therapy requires only a moderate dose of met ronidazole (1.6-2.2 g/day), avoiding the side effects of larger doses. The combination therapy therefore merits further evaluation.