滴虫治疗的新进展，包括持续性感染和 5-硝基咪唑类药物超敏反应。
Updates in trichomonas treatment including persistent infection and 5-nitroimidazole hypersensitivity.
机构信息
Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
出版信息
Curr Opin Infect Dis. 2020 Feb;33(1):73-77. doi: 10.1097/QCO.0000000000000618.
PURPOSE OF REVIEW
The purpose of this review is to update information on treatment of Trichomonas vaginalis. T. vaginalis is estimated to be the most common treatable sexually transmitted infection. In the world and is associated with poor birth outcomes, cervical cancer, sperm motility and morphology issues, and HIV acquisition and transmission.
RECENT FINDINGS
The efficacy of the recommended 2-g oral single-dose metronidazole (MTZ) for the treatment of T. vaginalis in women has recently been challenged. Two recent multicentered randomized trials and a meta-analysis have demonstrated that the 7-day dose of MTZ 500 mg twice daily was nearly two times more efficacious at clearing infection compared with the 2-g dose. Partner treatment is also essential, since up to 70% of male sexual partners can be infected and rescreening of treated women at 3 months is also recommended given the high repeat infection rates. Future studies should examine the importance of treating asymptomatic T. vaginalis, best treatment for men, the influence of the microbiome on treatment efficacy and different formulations of intravaginal treatments for hypersensitivity.
SUMMARY
7-day 500 mg twice daily MTZ should be used as the first line treatment for T. vaginalis-infected women.
目的综述
本综述旨在更新有关阴道毛滴虫治疗的信息。阴道毛滴虫估计是世界上最常见的可治疗性传播感染，与不良的出生结局、宫颈癌、精子活力和形态问题以及 HIV 获得和传播有关。
最近的发现
最近，人们对推荐的 2 克口服单剂量甲硝唑（MTZ）治疗女性阴道毛滴虫的疗效提出了质疑。最近两项多中心随机试验和一项荟萃分析表明，与 2 克剂量相比，每日两次口服 500 毫克 MTZ 的 7 天剂量在清除感染方面的疗效几乎高出两倍。伴侣治疗也很重要，因为多达 70%的男性性伴侣可能被感染，鉴于高重复感染率，还建议在 3 个月时对接受治疗的女性进行重新筛查。未来的研究应探讨治疗无症状阴道毛滴虫的重要性、男性的最佳治疗方法、微生物组对治疗效果的影响以及治疗过敏的不同阴道内制剂。
总结
7 天 500 毫克两次每日 MTZ 应作为治疗阴道毛滴虫感染女性的一线药物。
Zotero 插件