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

The present study was conducted on 30 female patients with metronidazole 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 (2 g daily for 7 days) n = 10; G. II: patients received (100 mg N-9 vaginal suppository daily for 7 days) n = 10; G. III: patients receiving conventional MNZ dose (1 g daily for 7 days) plus (a 100 mg 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 & 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.