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JAC Advance Access published online on December 12, 2005
Journal of Antimicrobial Chemotherapy, 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
Received November 16, 2004
Revised May 27, 2005
Accepted October 19, 2005

Original article

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

C. Blaha 1, M. Duchêne 2, H. Aspöck 1, and J. Walochnik 1 *

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

* To whom correspondence should be addressed.
J. Walochnik, E-mail: julia.walochnik{at}meduniwien.ac.at


  Abstract

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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