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JAC Advance Access originally published online on December 12, 2005
Journal of Antimicrobial Chemotherapy 2006 57(2):273-278; doi:10.1093/jac/dki417
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

In vitro activity of hexadecylphosphocholine (miltefosine) against metronidazole-resistant and -susceptible strains of Trichomonas vaginalis

C. Blaha1, M. Duchêne2, H. Aspöck1 and J. Walochnik1,*

1 Department of Medical Parasitology, Clinical Institute of Hygiene and Medical Microbiology, Medical University of Vienna, Kinderspitalgasse 15, 1095 Vienna, Austria; 2 Department of Physiology and Pathophysiology, Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1095 Vienna, Austria

Received 16 November 2004; returned 15 May 2005; revised 27 May 2005; accepted 19 October 2005

* Corresponding author. Tel: +43-1-40490-79446; Fax: +43-1-40490-79435; E-mail: julia.walochnik{at}meduniwien.ac.at

Objectives: Trichomonas vaginalis is the causative agent of trichomoniasis, a sexually transmitted disease with worldwide significance. Trichomoniasis can be treated with metronidazole; however, resistant strains of T. vaginalis have been isolated and there is a lack of useful alternative drugs. The aim of the present study was to examine the activity of hexadecylphosphocholine (HePC; miltefosine), a membrane-active alkylphospholipid, that is licensed as an antileishmanial agent against T. vaginalis.

Methods: The efficacy of HePC after 30 min, 1 h, 16 h and 24 h against four different T. vaginalis strains (with varying resistance to metronidazole) was evaluated.

Results: It was shown that all isolates, including the metronidazole-resistant strains, were susceptible to HePC, with EC50s of between 8 and 40 µM and EC90s of between 8 and 80 µM depending on time and on the medium used for the experiments. Treatment of trichomonads with HePC resulted in rounding up and, at concentrations of ≥40 µM, in subsequent total lysis of the organisms.

Conclusions: HePC may be a promising new candidate for the treatment of trichomoniasis.

Keywords: protozoa , treatment , drug resistance , STD


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