Secnidazole for Trichomoniasis in Women and Men.

Abstract

INTRODUCTION:

Secnidazole (SEC), newly FDA-approved for trichomoniasis, is a potent 5-nitroimidazole with selective toxicity against various infections. It has been used internationally to treat trichomoniasis, bacterial vaginosis, and other infections for decades. Trichomoniasis is the most common non-viral sexually transmitted infection worldwide and is associated with significant morbidity. In comparison to the only other approved treatments for trichomoniasis in the U.S.-metronidazole and tinidazole-SEC has favorable pharmacokinetics, including a longer half-life, and a lower minimal lethal concentration against Trichomonas vaginalis.

OBJECTIVES:

Provide an updated, comprehensive review of the literature evaluating SEC as a treatment for trichomoniasis in women and men.

METHODS:

We conducted a search to identify existing research on SEC and trichomoniasis. On August 6, 2021, we searched MEDLINE using the terms "secnidazole" and "trichomon.*" We excluded reviews, editorials, case reports, and small case series.

RESULTS:

We identified 29 articles; 14 of which were included: 5 reported in vitro pharmacologic data on SEC, 6 were observational studies, and 4 were controlled clinical trials (1 observational study also reported in vitro pharmacologic data). Six studies reported data on women only, 1 on men only, and 3 on women and men. These studies showed that SEC-as a single dose or 3-day course-had comparable efficacy to multi-dose metronidazole for treating trichomoniasis in women and men, was generally well tolerated by patients, and had a favorable pharmacokinetic profile. A single 2-g dose of SEC also led to a microbiologic cure rate of 92.2% in the first randomized, double-blind, placebo-controlled study of trichomonas-infected US-based women.

CONCLUSION:

SEC is an efficacious and safe treatment for women and men with trichomoniasis. Single-dose administration makes it a favorable treatment option for patients, especially in cases where adherence to other multi-dose treatment regimens could be problematic. Christina A. Muzny and Olivia T. Van Gerwen. Secnidazole for Trichomoniasis in Women and Men. Sex Med Rev 2022;10:255-262.

• Authors: Christina A Muzny, Olivia T Van Gerwen
• Journal: Sexual medicine reviews (Sex Med Rev) Vol. 10 Issue 2 Pg. 255-262 (04 2022) ISSN: 2050-0521 [Electronic] Netherlands
• PMID: 35153156 (Publication Type: Journal Article, Review, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Chemical References

• Metronidazole
• secnidazole

Topics

• Female
• Humans
• Male
• Metronidazole (analogs & derivatives, pharmacology, therapeutic use)
• Observational Studies as Topic
• Randomized Controlled Trials as Topic
• Trichomonas Infections (drug therapy)
• Trichomonas vaginalis
• Vaginosis, Bacterial (chemically induced, drug therapy, microbiology)