In vitro effects of various plants extracts on the growth of Trichomonas vaginalis.

Trichomoniasis is a common sexually transmitted disease (STD) caused by a protozoan parasite called Trichomonas vaginalis. This disease, with roughly 170 million new infected people worldwide per year, is associated with various problems such as pre-term delivery, high infant mortality or low birth weight. In addition, trichomoniasis increases patient susceptibility to HIV infection. The mainstay medication for trichomoniasis is metronidazole, but some resistant strains to this treatment have been identified. Moreover, treatment with metronidazole is associated with numerous side effects. Thus efforts to identify new alternative drugs in order to control trichomoniasis are vital. The use of medicinal herbs has gained widespread acceptance in both developing and non-developing societies because of owing to fewer side effects and better patient tolerance. In our search for alternative drugs in the treatment of trichomoniasis, we reviewed the effect of different plant extracts on Trichomonas vaginalis in vitro.

Efficacy of the Mentha crispa in the treatment of women with Trichomonas vaginalis infection.

PURPOSE: The aim of this study was to evaluate the efficacy of Mentha crispa in the treatment of women with Trichomonas vaginalis infection (TVI). METHODS: This was a randomized, double-blind, and controlled clinical trial consisting of three phases, pre-treatment, treatment, and post-treatment. Sixty female patients were randomized to a treatment group, M. crispa (24 mg) or secnidazole (2,000 mg), both consisting of single dose. RESULTS: After treatment the proportion of patients without TVI in secnidazole group was 96.6% and in the M. crispa group was 90%, no difference was found between groups (P = 0.6120). We observed improvement in vaginal discharge, malodorous vaginal secretion, dyspareunia, dysuria, pelvic pain, and burning and itching in the genital area in patients of both groups of treatment, with no statistically significant differences between them (P > 0.05). Adverse effects were significantly higher (P = 0.0006) in the secnidazole group (66.6%) than in the M. crispa group (20%), that being mostly nausea and metallic taste with statistically significant differences between treatment groups (P < 0.001). CONCLUSION: This study is the first to show that M. crispa is effective and safe, representing an alternative for the treatment of TVI in women.

Tinidazole for the treatment of vaginal infections.

Tinidazole has been used for vaginal infection worldwide but not in the US for > 40 years. Recently, tinidazole has been re-introduced and approved by the FDA for trichomoniasis and restudied as an alternative to metronidazole for bacterial vaginosis. In vitro antimicrobial activity and pharmacokinetics studies indicate that tinidazole has minor but possibly relevant antimicrobial as well as pharmacokinetic advantages when compared directly with metronidazole. Clinical comparison has been infrequent although the limited head-to-head studies indicate minimal therapeutic advantage with tinidazole. Perhaps the more relevant differences relate to the enhanced tolerance and reduced toxicity of tinidazole. Ongoing, as yet incomplete, studies directly comparing the clinical efficacy of metronidazole and tinidazole for bacterial vaginosis should clarify the status of tinidazole; however, cure rates are unlikely to be significantly different. Although uncommon, high-level trichomonal metronidazole resistance can be reliably cured by using tinidazole, which is an invaluable advantage.

A study of 4- and 7-day triple therapy with rabeprazole, high-dose levofloxacin and tinidazole rescue treatment for Helicobacter pylori eradication.

BACKGROUND: Helicobacter pylori treatment failure is becoming an emergent problem in clinical practice. Shorter treatment duration should improve compliance to therapy and keep an acceptable H. pylori eradication rate. AIMS: To evaluate the efficacy of two rabeprazole, high-dose levofloxacin and tinidazole-based regimens as 'rescue' treatment for H. pylori eradication in an open-label, randomized, pilot study carried out in a clinical practice setting. METHODS: Eighty-five consecutive patients who have previously failed at least one H. pylori eradication attempt were randomized to receive rabeprazole (20 mg, b.d.), levofloxacin (500 mg, b.d.) and tinidazole (500 mg, b.d.) either for 4 (4-day RLT, n = 42) or 7 days (7-day RLT, n = 43). Cure of H. pylori infection was assessed by means of 13C-urea breath test. RESULTS: The 7-day RLT achieved 84% (95% CI: 69-93%) and 86% (95% CI: 72-95%) eradication rates in intention-to-treat and per-protocol analyses respectively. The shorter treatment obtained an 83% (95% CI: 69-93%) eradication rate in both intention-to-treat and per-protocol analysis. Both regimens were well tolerated, although patients who received the 4-day RLT reported fewer side-effects. CONCLUSIONS: In patients who have previously failed at least one H. pylori eradication attempt, both 4- and 7-day rabeprazole, high-dose levofloxacin, tinidazole-based regimens are effective in curing the infection in more than 80% of patients.

Effect of intestinal parasite treatment on the efficacy of oral iodized oil for correcting iodine deficiency in schoolchildren.

Oral supplementation with iodized oil for correction of iodine deficiency in a population has advantages over intramuscular injection but the duration of effect is shorter. The relation of intestinal parasite treatment and efficacy of oral iodized oil was examined in an intervention study in 8-10-y-old schoolchildren in Malawi. Severely iodine-deficient schoolchildren with a single parasitic infestation of Ascaris lumbricoides (n = 44), hookworm (n = 42), or Entamoeba histolytica (n = 24) were randomly allocated to receive or not receive treatment before taking a 1-mL oral supplement (490 mg I) of iodized ethyl esters from poppy seed oil. The urinary iodine concentration was measured at various time points after supplementation to define the time intervals before urinary iodine concentrations returned to 0.40 mumol/L, indicating moderate iodine deficiency. Treatment with metronidazole for E. histolytica increased the protection period from 2.0 to 21.0 wk (P < 0.05). For all untreated children together, the duration of effect was 9.2 wk shorter (P < 0.001) than that for their treated peers (16.8 wk). We conclude that intestinal parasitic infestations reduce the efficacy of oral supplementation with iodized ethyl esters by interfering with absorption.