Assuntos
Antitricômonas/farmacologia , Alucinógenos/análise , Metronidazol/farmacologia , Fenciclidina/urina , Detecção do Abuso de Substâncias/métodos , Adulto , Antitricômonas/uso terapêutico , Infecções por Blastocystis/tratamento farmacológico , Blastocystis hominis , Reações Falso-Positivas , Humanos , Imunoensaio , Masculino , Metronidazol/uso terapêuticoRESUMO
BACKGROUND: In the United States 19 million people acquire a sexually transmitted disease every year. Sexually transmitted diseases impact in gynecological terms because they may cause sterility, infertility and ectopic pregnancy. OBJECTIVE: To compare the effectiveness of two combinations of three oral antimicrobial drugs in the treatment of mixed cervical-vaginal infections, included those caused by Mycoplasma and Chlamydia trachomatis. MATERIAL AND METHOD: Aclinical, random, comparative, double-blind study included 50 patients assisting to infectology consult with diagnosis of mixed cervical-vaginal infection. Patients were divided into two groups: Group A (n = 25): fluconazole 37.5 mg, tinidazole 500 mg and azithromycin 250 mg; group B (n = 25): fluconazole 37.5 mg, tinidazole 500 mg and clindamycin 312.5 mg. Patients of both groups received two tablets twice p.o. for one day. Cultures were performed to corroborate the diagnosis and then to demonstrate effectiveness of the schemes studied. For the analysis of the data we used measures of central tendency, dispersion and inferential statistics for comparison of proportions by c2 and Fisher's exact tests with a significance level of p < 0.05. RESULTS: All patient got clinical cure; however, regarding the microbiologic eradication a positive case was identified in group A, requiring rescue treatment. The compliance in both groups was of 100%. In both groups, statistical analysis did not show significant differences. Three patients in group A had mild adverse effects. Patients mean age was 33.4 +/- 5.3 years. CONCLUSIONS: Both treatments showed similar effectiveness against mixed cervical-vaginal infections. Microbiological efficacy was of 96% and 100% in group A and B, respectively, besides, scheme of group B was better tolerated.
Assuntos
Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Antitricômonas/uso terapêutico , Azitromicina/uso terapêutico , Clindamicina/uso terapêutico , Fluconazol/uso terapêutico , Infecções por Mycoplasma/tratamento farmacológico , Tinidazol/uso terapêutico , Doenças do Colo do Útero/tratamento farmacológico , Doenças do Colo do Útero/microbiologia , Doenças Vaginais/tratamento farmacológico , Doenças Vaginais/microbiologia , Adulto , Infecções por Chlamydia/tratamento farmacológico , Método Duplo-Cego , Quimioterapia Combinada , Feminino , HumanosRESUMO
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.
Assuntos
Antitricômonas/uso terapêutico , Mentha , Metronidazol/análogos & derivados , Fitoterapia , Extratos Vegetais/uso terapêutico , Vaginite por Trichomonas/tratamento farmacológico , Descarga Vaginal/parasitologia , Adulto , Antitricômonas/efeitos adversos , Método Duplo-Cego , Dispareunia/parasitologia , Disuria/parasitologia , Feminino , Humanos , Masculino , Metronidazol/efeitos adversos , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Dor Pélvica/parasitologia , Extratos Vegetais/efeitos adversos , Prurido/parasitologia , Estatísticas não Paramétricas , Distúrbios do Paladar/induzido quimicamente , Trichomonas vaginalis , Adulto JovemRESUMO
Pleural empyema formation is one of the potential complications of lower respiratory tract infections and it is characterized by bacterial organisms seen on gram stain or the aspiration of pus on thoracentesis. Very rarely empyema can be caused by trichomonas species, of which Trichomonas Tenax appears to be the most common cause. In this article we report the case of a 51-year-old man who developed a pleural empyema caused by trichomonas, and review the available literature of this rare infection of unknown incidence and uncertain pathogenetic significance. Our patient was treated with metronidazole, however complete cure was not achieved and pulmonary decortication was necessary for the successful outcome. As far as we know, this is the first case of pleural empyema caused by trichomonas reported in Chile.
La formación de un empiema pleural es una de las potenciales complicaciones de las infecciones de la vía aérea inferior, y se caracteriza por la observación de bacterias en la tinción de Gram, o la aspiración de pus en la toracocentesis. Muy infrecuentemente el empiema puede ser causado por alguna de las especies de tricomonas, de las cuales Trichomonas Tenax parece ser la causa más común. En este artículo, reportamos el caso de un hombre de 51 años que desarrolló un empiema pleural causado por tricomonas, y revisamos la literatura disponible de esta rara infección, de incidencia desconocida, y significancia patogénica incierta. Nuestro paciente fue tratado con metronidazol, observándose sólo una respuesta parcial, necesitándose decorticación pulmonar para una recuperación completa. Hasta donde sabemos, este es el primer caso de empiema pleural causado por tricomonas reportado en Chile.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Empiema Pleural/etiologia , Empiema Pleural/terapia , Tricomoníase/complicações , Tricomoníase/terapia , Antitricômonas/uso terapêutico , Drenagem , Empiema Pleural/cirurgia , Empiema Pleural/parasitologia , Empiema Pleural/tratamento farmacológico , Metronidazol/uso terapêutico , Toracostomia , Tricomoníase/cirurgia , Tricomoníase/tratamento farmacológicoRESUMO
Bond-based quadratic indices, new TOMOCOMD-CARDD molecular descriptors, and linear discriminant analysis (LDA) were used to discover novel lead trichomonacidals. The obtained LDA-based quantitative structure-activity relationships (QSAR) models, using nonstochastic and stochastic indices, were able to classify correctly 87.91% (87.50%) and 89.01% (84.38%) of the chemicals in training (test) sets, respectively. They showed large Matthews correlation coefficients of 0.75 (0.71) and 0.78 (0.65) for the training (test) sets, correspondingly. Later, both models were applied to the virtual screening of 21 chemicals to find new lead antitrichomonal agents. Predictions agreed with experimental results to a great extent because a correct classification for both models of 95.24% (20 of 21) of the chemicals was obtained. Of the 21 compounds that were screened and synthesized, 2 molecules (chemicals G-1, UC-245) showed high to moderate cytocidal activity at the concentration of 10 microg/ml, another 2 compounds (G-0 and CRIS-148) showed high cytocidal activity only at the concentration of 100 microg/ml, and the remaining chemicals (from CRIS-105 to CRIS-153, except CRIS-148) were inactive at these assayed concentrations. Finally, the best candidate, G-1 (cytocidal activity of 100% at 10 microg/ml) was in vivo assayed in ovariectomized Wistar rats achieving promising results as a trichomonacidal drug-like compound.
Assuntos
Antitricômonas/química , Antitricômonas/farmacologia , Desenho Assistido por Computador , Avaliação Pré-Clínica de Medicamentos/métodos , Software , Trichomonas vaginalis/efeitos dos fármacos , Adulto , Animais , Antitricômonas/uso terapêutico , Análise Discriminante , Farmacorresistência Bacteriana , Feminino , Humanos , Estrutura Molecular , Ovariectomia , Ratos , Ratos Wistar , Tricomoníase/tratamento farmacológicoAssuntos
Antifúngicos/uso terapêutico , Antiprotozoários/uso terapêutico , Candidíase Vulvovaginal/tratamento farmacológico , Vaginite por Trichomonas/tratamento farmacológico , Vaginose Bacteriana/tratamento farmacológico , Administração Oral , Antifúngicos/administração & dosagem , Antiprotozoários/administração & dosagem , Antitricômonas/administração & dosagem , Antitricômonas/uso terapêutico , Candidíase Vulvovaginal/complicações , Quimioterapia Combinada , Feminino , Fluconazol/administração & dosagem , Fluconazol/uso terapêutico , Humanos , Itraconazol/administração & dosagem , Itraconazol/uso terapêutico , Metronidazol/administração & dosagem , Metronidazol/análogos & derivados , Metronidazol/uso terapêutico , Cooperação do Paciente , Tinidazol/administração & dosagem , Tinidazol/uso terapêutico , Resultado do Tratamento , Vaginite por Trichomonas/complicações , Vaginose Bacteriana/complicaçõesRESUMO
The protozoan parasite Giardia lamblia is a major cause of waterborne enteric disease worldwide. Lectins are proteins that bind to carbohydrate (sugar) moieties. Potential targets for lectins are found on the surface of most single-celled organisms. Modest concentrations of wheat germ agglutinin (WGA) have been shown to inhibit G. lamblia excystation and trophozoite growth in vitro and can reduce cyst passage in mice infected with the closely related protozoan parasite, G. muris. Commercial preparations of wheat germ (WG) contain 13-53 microg of WGA per gram. We performed a double-masked, placebo-controlled study of dietary supplementation with WG in 63 subjects with giardiasis in Montreal and Lima (25 asymptomatic patients passing cysts; 38 patients with symptoms). Asymptomatic subjects received WG (2 g, 3 times a day) or placebo (cornstarch, 2 g, 3 times a day) for 10 days, followed by metronidazole (250 mg 3 times a day) for 7 days. Symptomatic subjects received metronidazole (250 mg 3 times a day) plus either WG or placebo for 7 days. Stool specimens were collected every day (Montreal) or every other day (Lima) for 10 days and on Day 35 for microscopic examination and coproantigen determination. Subjects kept a diary of symptoms for 10 days after recruitment. In asymptomatic subjects, both cyst passage and coproantigen levels were reduced by approximately 50% in those taking WG compared with the placebo group (P < 0.01 and P = 0.06, respectively). In symptomatic subjects, cyst passage and coproantigen levels fell precipitously in response to metronidazole therapy, and there were no clinically important differences between those receiving supplemental WG or placebo. However, symptoms appear to have resolved more rapidly in the subjects taking WG in addition to metronidazole. The WG supplement was well tolerated in both symptomatic and asymptomatic subjects. These data suggest that components of WG, possibly WGA, either alone or in combination with antiprotozoal agents, can influence the course of human giardiasis.
Assuntos
Antitricômonas/uso terapêutico , Suplementos Nutricionais , Giardíase/tratamento farmacológico , Fitoterapia , Triticum , Aglutininas do Germe de Trigo/uso terapêutico , Adulto , Animais , Antitricômonas/administração & dosagem , Método Duplo-Cego , Fezes/parasitologia , Feminino , Giardia lamblia/isolamento & purificação , Humanos , Masculino , Metronidazol/administração & dosagem , Metronidazol/uso terapêutico , Peru , Lectinas de Plantas , Quebeque , Resultado do Tratamento , Aglutininas do Germe de Trigo/administração & dosagemRESUMO
The anthelmintic effect of tinidazole (100 mg/kg per day for 3 successive days) was tested in male Swiss CF-1 mice infected with second-stage Toxocara canis larvae at challenge doses of 250, 500, 1000, and 1500 embryonated eggs per mouse. The drug was given orally on days 3-5 postinfection (p.i.) to one-half of the animals, and all mice were killed on day 40 p.i. The number of larvae recovered from each mouse's brain and skeletal muscle was then scored in both groups. Tinidazole yielded a highly significant reduction in the total recovery of larvae from the test animals' brains at the second and third inoculum levels but no statistically significant reduction at the highest larval dose as compared with the values obtained in the untreated control animals.
Assuntos
Antitricômonas/uso terapêutico , Encefalopatias/tratamento farmacológico , Tinidazol/uso terapêutico , Toxocara canis/efeitos dos fármacos , Toxocaríase/tratamento farmacológico , Animais , Encéfalo/parasitologia , Encefalopatias/parasitologia , Modelos Animais de Doenças , Progressão da Doença , Larva , Masculino , Camundongos , Músculo Esquelético/parasitologia , Contagem de Ovos de Parasitas , Toxocara canis/isolamento & purificação , Toxocaríase/parasitologiaRESUMO
BACKGROUND: The addition of omeprazole to classical triple therapy for eradication of H. pylori may enhance compliance through reducing ulcer symptoms and side-effects. The aim of this study was to investigate the effects of a 5-day administration of omeprazole on metronidazole pharmacokinetics. METHODS: Fourteen healthy male volunteers were selected. The study had an open, randomized, two-period crossover design with a 21-day washout period between the phases. Plasma concentrations of metronidazole and its hydroxy-metabolite were measured by reversed-phase HPLC with ultraviolet detection. RESULTS: Administration of omeprazole did not affect the pharmacokinetic parameters of orally administered metronidazole. CONCLUSION: Our results indicate that short-term treatment with omeprazole in healthy volunteers does not alter the extent or the rate of metronidazole absorption, and does not affect metronidazole clearance.
Assuntos
Antiulcerosos/farmacologia , Antitricômonas/farmacocinética , Ácido Gástrico/metabolismo , Metronidazol/farmacocinética , Omeprazol/farmacologia , Administração Oral , Adulto , Antiulcerosos/administração & dosagem , Antiulcerosos/uso terapêutico , Antitricômonas/efeitos adversos , Antitricômonas/uso terapêutico , Disponibilidade Biológica , Estudos Cross-Over , Interações Medicamentosas , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Humanos , Masculino , Metronidazol/efeitos adversos , Metronidazol/uso terapêutico , Omeprazol/administração & dosagem , Omeprazol/uso terapêuticoRESUMO
OBJECTIVE: Evaluation of oral treatment in vaginitis and vaginosis using Itraconazol and sechidazol, in comparison to topic treatment using vaginal ovules of acetonido of fluocinolona 0.50 mg, nistatina 100,000 U and metronidazol 500 mg. DESIGN: Longitudinal, prospective and open comparative study. PLACE: Servicio de Reproducción Humana(Human Reproduction Department), Centro Médico Nacional "20 de Noviembre". MATERIAL AND METHODOLOGY: Forty female patients, without any relevant differences in their general characteristics, chose diagnosis was vaginitis and vaginosis, who were medically treated through external consultation, divided in two groups of twenty each one. Group 1 oral treatment with itraconazol and secnidazol. Group 2 had topic treatment with fluocinolona, nistatina and metronidazol. All of the patients were controlled in seven and fourteen days time, in order to evaluate the intensity of their clinical symptomatology, as well as the efficacy in both ways of treatment. RESULTS: Leukorrhea was the most important symptom in all the cases, going from minor to serious white discharge. After the treatment, we found a relevant difference statistically significative in patients treated with intraconazol and secnidazol. We did not find any differences in relation to ardor, pruritus, dispareunia and disuria at post-treatment evaluation. However, group 1 betterment was statistically significative between the first and the seventh days of treatment. CONCLUSION: Treating vaginitis or vaginosis (or both) with itraconazol and secnidazol takes less time for betterment in addition to comfort and easiness of oral administration; therefore, we consider them proper medicines in these specific cases.