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. 2000;2003(2):CD000218.
doi: 10.1002/14651858.CD000218.

Interventions for treating trichomoniasis in women

A M Gülmezoglu  1 , F Forna
Affiliations

Interventions for treating trichomoniasis in women

A M Gülmezoglu et al. Cochrane Database Syst Rev. 2000.

Update in

Abstract

Objectives: Around 120 million women worldwide suffer from Trichomonas vaginalis vaginitis every year. The infection is sexually transmitted and is believed to facilitate HIV transmission. The objective of the review is to assess the effects of various treatment strategies for trichomoniasis in women.

Search strategy: We searched the Cochrane Controlled Trials Register, MEDLINE, and EMBASE. Trials were also identified from reference lists of reviews, through pharmaceutical companies, and by informal discovery. Only published data were used in this review. Date of the most recent search: May, 1999.

Selection criteria: Randomized or quasi-randomized trials in women with trichomoniasis of different treatment strategies, different antitrichomonal drugs or doses were eligible.

Data collection and analysis: Trial quality was assessed and data extracted by two reviewers independently using standard criteria.

Main results: Fifty-two trials were included. Nitroimidazoles seem to be effective in achieving parasitological cure in the short term follow-ups. Partner treatment can be effective in decreasing longer term re-infection rates.

Reviewer's conclusions: Parasitological cure can be achieved by single oral dose of nitroimidazoles. Further research should focus on developing effective partner treatment strategies to prevent re-infections and reduce trichomoniasis prevalence.

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Conflict of interest statement

We certify that we have no affiliations with or involvement in any organisation or entity with a direct financial interest in the subject matter of the review (e.g. employment, consultancy, stock ownership, honoraria, expert testimony).

Figures

Analysis 1.1
Analysis 1.1
Comparison 1 Treatment versus no treatment, Outcome 1 No parasitological cure (day 4 to 2 weeks).
Analysis 1.2
Analysis 1.2
Comparison 1 Treatment versus no treatment, Outcome 2 No parasitological cure (6 weeks).
Analysis 1.3
Analysis 1.3
Comparison 1 Treatment versus no treatment, Outcome 3 No parasitological cure (3 months).
Analysis 1.4
Analysis 1.4
Comparison 1 Treatment versus no treatment, Outcome 4 Side effects.
Analysis 2.1
Analysis 2.1
Comparison 2 Short versus long treatment, Outcome 1 No parasitological cure.
Analysis 2.2
Analysis 2.2
Comparison 2 Short versus long treatment, Outcome 2 Side effects.
Analysis 3.1
Analysis 3.1
Comparison 3 Oral versus intravaginal treatment, Outcome 1 No parasitological cure.
Analysis 3.2
Analysis 3.2
Comparison 3 Oral versus intravaginal treatment, Outcome 2 Persistent itching.
Analysis 3.3
Analysis 3.3
Comparison 3 Oral versus intravaginal treatment, Outcome 3 Persistent discharge.
Analysis 3.4
Analysis 3.4
Comparison 3 Oral versus intravaginal treatment, Outcome 4 Persistent dysuria.
Analysis 4.1
Analysis 4.1
Comparison 4 Oral versus oral plus intravaginal, Outcome 1 No parasitological cure (2 weeks).
Analysis 4.2
Analysis 4.2
Comparison 4 Oral versus oral plus intravaginal, Outcome 2 No parasitological cure (6 weeks).
Analysis 4.3
Analysis 4.3
Comparison 4 Oral versus oral plus intravaginal, Outcome 3 No parasitological cure (3 months).
Analysis 5.1
Analysis 5.1
Comparison 5 Partner treatment versus no partner treatment, Outcome 1 No parasitological cure (at average 10 days).
Analysis 5.2
Analysis 5.2
Comparison 5 Partner treatment versus no partner treatment, Outcome 2 No parasitological cure (at average 2 months).
Analysis 5.3
Analysis 5.3
Comparison 5 Partner treatment versus no partner treatment, Outcome 3 No parasitological cure with intercourse (at 2 months).
Analysis 6.1
Analysis 6.1
Comparison 6 Metronidazole versus ornidazole, Outcome 1 No parasitological cure (day 3).
Analysis 6.2
Analysis 6.2
Comparison 6 Metronidazole versus ornidazole, Outcome 2 No parasitological cure (4 weeks).
Analysis 6.3
Analysis 6.3
Comparison 6 Metronidazole versus ornidazole, Outcome 3 Side effects.
Analysis 7.1
Analysis 7.1
Comparison 7 Metronidazole versus nimorazole, Outcome 1 No parasitological cure.
Analysis 7.2
Analysis 7.2
Comparison 7 Metronidazole versus nimorazole, Outcome 2 Side effects.
Analysis 8.1
Analysis 8.1
Comparison 8 Metronidazole versus nifuratel, Outcome 1 No parasitological cure.
Analysis 8.2
Analysis 8.2
Comparison 8 Metronidazole versus nifuratel, Outcome 2 Side effects.
Analysis 9.1
Analysis 9.1
Comparison 9 Metronidazole versus tinidazole, Outcome 1 No parasitological cure (3‐21 days).
Analysis 9.2
Analysis 9.2
Comparison 9 Metronidazole versus tinidazole, Outcome 2 No parasitological cure (4 weeks).
Analysis 9.3
Analysis 9.3
Comparison 9 Metronidazole versus tinidazole, Outcome 3 No clinical improvement.
Analysis 9.4
Analysis 9.4
Comparison 9 Metronidazole versus tinidazole, Outcome 4 Side effects.
Analysis 10.1
Analysis 10.1
Comparison 10 Metronidazole versus nitrimidazine, Outcome 1 No parasitological cure.
Analysis 10.2
Analysis 10.2
Comparison 10 Metronidazole versus nitrimidazine, Outcome 2 Side effects.
Analysis 11.1
Analysis 11.1
Comparison 11 Intravaginal: metronidazole versus methyl patricin, Outcome 1 No parasitological cure.
Analysis 12.1
Analysis 12.1
Comparison 12 Intravaginal: metronidazole versus lotrimazole, Outcome 1 No parasitological cure (2 weeks).
Analysis 13.1
Analysis 13.1
Comparison 13 Intravaginal: clotrimazole versus AVC suppositories, Outcome 1 No parasitological cure (2‐3 weeks).
Analysis 13.2
Analysis 13.2
Comparison 13 Intravaginal: clotrimazole versus AVC suppositories, Outcome 2 No parasitological cure (4‐6 weeks).
Analysis 13.3
Analysis 13.3
Comparison 13 Intravaginal: clotrimazole versus AVC suppositories, Outcome 3 Any side effect.
Analysis 14.1
Analysis 14.1
Comparison 14 Tinidazole versus ornidazole, Outcome 1 No parasitological cure (days 3‐14).
Analysis 14.2
Analysis 14.2
Comparison 14 Tinidazole versus ornidazole, Outcome 2 No parasitological cure (4 weeks).
Analysis 14.3
Analysis 14.3
Comparison 14 Tinidazole versus ornidazole, Outcome 3 No clinical cure.
Analysis 14.4
Analysis 14.4
Comparison 14 Tinidazole versus ornidazole, Outcome 4 Side effects.
Analysis 15.1
Analysis 15.1
Comparison 15 Tinidazole versus nimorazole, Outcome 1 No parasitological cure.
Analysis 15.2
Analysis 15.2
Comparison 15 Tinidazole versus nimorazole, Outcome 2 No clinical cure.
Analysis 16.1
Analysis 16.1
Comparison 16 Tinidazole versus carnidazole, Outcome 1 No parasitological cure (1 week).
Analysis 16.2
Analysis 16.2
Comparison 16 Tinidazole versus carnidazole, Outcome 2 No parasitological cure (2 weeks).
Analysis 16.3
Analysis 16.3
Comparison 16 Tinidazole versus carnidazole, Outcome 3 Any side effect.
Analysis 17.1
Analysis 17.1
Comparison 17 Ornidazole versus nimorazole, Outcome 1 No parasitological cure.
Analysis 17.2
Analysis 17.2
Comparison 17 Ornidazole versus nimorazole, Outcome 2 No clinical cure.
Analysis 18.1
Analysis 18.1
Comparison 18 Metronidazole low dose (1g or less) versus standard dose (1.5g or more), Outcome 1 No parasitological cure (1‐2 weeks).
Analysis 18.2
Analysis 18.2
Comparison 18 Metronidazole low dose (1g or less) versus standard dose (1.5g or more), Outcome 2 Side effects.
Analysis 19.1
Analysis 19.1
Comparison 19 Ornidazole 0.5‐1g versus 1.5‐2g, Outcome 1 No parasitological cure.
Analysis 19.2
Analysis 19.2
Comparison 19 Ornidazole 0.5‐1g versus 1.5‐2g, Outcome 2 No clinical cure.
Analysis 19.3
Analysis 19.3
Comparison 19 Ornidazole 0.5‐1g versus 1.5‐2g, Outcome 3 Any side effect.
Analysis 20.1
Analysis 20.1
Comparison 20 Nimorazole dose comparisons, Outcome 1 No parasitological cure.
Analysis 20.2
Analysis 20.2
Comparison 20 Nimorazole dose comparisons, Outcome 2 No clinical cure.
Analysis 21.1
Analysis 21.1
Comparison 21 Carnidazole 1.5g versus 2g, Outcome 1 No parasitological cure (1‐3 weeks).
Analysis 22.1
Analysis 22.1
Comparison 22 Intravaginal: fenticonazole 600 mg versus 1000 mg, Outcome 1 No parasitological cure.
Analysis 23.1
Analysis 23.1
Comparison 23 Nifuratel 7 days versus 10 days, Outcome 1 No parasitological cure.
Analysis 24.1
Analysis 24.1
Comparison 24 Oral metronidazole versus intravaginal clotrimazole, Outcome 1 No parasitological cure (2‐3 weeks).
Analysis 24.2
Analysis 24.2
Comparison 24 Oral metronidazole versus intravaginal clotrimazole, Outcome 2 No parasitological cure (4‐6 weeks).
Analysis 24.3
Analysis 24.3
Comparison 24 Oral metronidazole versus intravaginal clotrimazole, Outcome 3 Any side effect.
Analysis 25.1
Analysis 25.1
Comparison 25 Oral metronidazole versus intravaginal AVC suppositories, Outcome 1 No parasitological cure (2‐3 weeks).
Analysis 25.2
Analysis 25.2
Comparison 25 Oral metronidazole versus intravaginal AVC suppositories, Outcome 2 No parasitological cure (4‐6 weeks).
Analysis 25.3
Analysis 25.3
Comparison 25 Oral metronidazole versus intravaginal AVC suppositories, Outcome 3 Any side effect.
Analysis 26.1
Analysis 26.1
Comparison 26 Oral plus intravaginal versus intravaginal, Outcome 1 No parasitological cure.
Analysis 27.1
Analysis 27.1
Comparison 27 Oral metronidazole versus intravaginal nonoxynol 9, Outcome 1 No parasitological cure.
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References

References to studies included in this review

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Additional references

    1. Khanna J, Look PFA, Griffin PD. Challenges in reproductive health research. Biennial Report 1992‐1993, WHO. Geneva: WHO, 1994.

References to other published versions of this review

    1. Gülmezoglu AM, Garner P. Trichomoniasis treatment in women: a systematic review. Tropical Medicine and International Health 1998;3(7):553‐558. - PubMed

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