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Arthur T Knackerbracket has found the following story:
A new study led by an infectious disease epidemiologist at Tulane University School of Public Health and Tropical Medicine could change the way doctors treat a common sexually transmitted disease.
Professor Patricia Kissinger and a team of researchers found the recommended single dose of medication isn't enough to eliminate trichomoniasis, the most common curable STD, which can cause serious birth complications and make people more susceptible to HIV. Results of the research are published in Lancet Infectious Diseases.
Globally, an estimated 143 million new cases of trichomoniasis among women occur each year and most do not have symptoms, yet the infection is causing unseen problems. The recommended treatment for more than three decades has been a single dose of the antibiotics metronidazole or tinidazole.
The researchers recruited more than 600 women for the randomized trial in New Orleans; Jackson, Mississippi; and Birmingham, Alabama. Half the women took a single dose of metronidazole and the other half received treatment over seven days.
Kissinger and her team found the women who received multiple doses of the treatment were half as likely to still have the infection after taking all the medication compared to women who only took a single dose.
-- submitted from IRC
Patricia Kissinger, et. al. Single-dose versus 7-day-dose metronidazole for the treatment of trichomoniasis in women: an open-label, randomised controlled trial. The Lancet Infectious Diseases, 2018; DOI: 10.1016/S1473-3099(18)30423-7
(Score: 3, Insightful) by FatPhil on Wednesday October 10 2018, @09:07AM (6 children)
This is why replication is vital in science. I'd even go as far as to say that without replication, it's not science. (And anyone who even considers stopping their initial tests part-way-through because the results they've got so far look so convincing should be given the boot.)
At least this is a small win for evidence-based medicine, but fixing bad things isn't that great - we should be trying to ensure the bad thing doesn't happen in the first place.
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 1, Interesting) by Anonymous Coward on Wednesday October 10 2018, @10:36AM
College gf caught this (mid-1970s) and I (guy) had to be tested as well--easy test, pee in a cup, wait a couple of days for results. The docs called it the ping pong disease back then, the organism might be eliminated from one partner with treatment but still be in the other (with no symptoms). Then passed back to the original partner. Turned out I was clear, and she could have contracted from an earlier partner and had no symptoms for a long time.
No mention in tfa if the experiment controlled for this problem. One link for "ping pong"
https://www.sciencedaily.com/terms/trichomoniasis.htm [sciencedaily.com]
(Score: 3, Insightful) by Muad'Dave on Wednesday October 10 2018, @11:47AM
Your points are valid and insightful, but there is a possibility that they did do their due diligence. When the drugs in question were first used against this organism, they may have worked 100% of the time with one dose. Since then the critter in question may have developed limited resistance, making subsequent doses necessary.
(Score: 3, Insightful) by The Shire on Wednesday October 10 2018, @01:15PM (1 child)
If you read the study or even the summary you'll see that going from 1 dose to 7 only reduces the chance of a persistent infection by 50%. This is a cost/benefit situation. The largest benefit comes from a single dose. If you increase the dose nearly 10 fold, you get some improvement but not enough to justify the increased risk of producing drug resistant strains. Antibiotics are not a miracle cure all, the more you take the more there is a risk they will stop working altogether.
This study reads more like a pharma subsidized marketing tool to increase sales without any consideration for the increased risk to the general public from creating new drug resistant strains.
(Score: 3, Insightful) by FatPhil on Wednesday October 10 2018, @09:44PM
I've always heard the pharma industry saying that the reason drug costs are so high is that for every one that comes to market there are 10 failures that need to have thier expensive R&D paid for. In which case, tripling production should only put up costs by a fraction of that.
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 0) by Anonymous Coward on Wednesday October 10 2018, @04:59PM
Well put. This is how they [allegedly] built the software for the [alleged] moon landing.
(Score: 4, Interesting) by All Your Lawn Are Belong To Us on Wednesday October 10 2018, @05:14PM
The cure was being called a cure because historically the rate was 90-95% effective for a single 2 gram dose. 90-95% effective is pretty darn effective, ain't it? And this was a front-line very low dose. For those it didn't cure further steps can be taken (like the larger/longer dose regimen).
There are only two drugs for trich anyway: Metronidazole and tinidazole. (There are far fewer antiparasitic drugs than antibiotic). Metronidazole is regarded as the more effective of the two, generally.
This study seems to question that effectiveness rate a bit (81% effective for the single dose and 89% effective for 7 day). It is known that about 2-5% of trich infections are metranidazole-resistant.
Currently both regimens are available. Typical course of treatment is to use the 2 gram single dose, and if reinfection is screened out (something the abstract of the study doesn't talk about but would be normal), then go with the 7 day higher dosage. This single study is just advocating a jump to the 7 day to get an extra 8% or so effectiveness at the outset.
As resistance grows, so must the tools change. Whether it's that time yet.... ask your doctor when you are diagnosed with Trichomoniasis (70% of those who have it are asymptomatic anyway....)
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