Effect of metronidazole ('Flagyl') upon non-gonococcal urethritis in the male.

Metronidazole (8823 RP; "Flagyl") is a nitroinidazole derivative which has been shewn to be highly active against T. vaginalis, not only in the laboratory (Cosar and Julou, 1959) but also in vivo against human trichomoniasis in the female (Durel, Roiron, Siboulet, and Borel, 1959, 1960; Durel, Couture, Collart, and Girot, 1960; Nicol, Barrow, and Redmond, 1960; Rodin, King, Nicol, and Barrow, 1960; Watt and Jennison, 1960; Willcox, 1960). At last, therefore, an effective systemic treatment for trichomoniasis is available and usually local therapy is no longer necessary. That T. vaginalis is found in males with nongonococcal urethritis (NGU) is well known. Sylvestre, Belanger, and Gallai (1960) tabulated the incidence found by numerous workers: the highest (in 68 per cent. of NGU cases) was reported in the series of Coutts and Silva-lnzunza (1957) in Chile, and an incidence of 41 per cent. was reported by Feo and Fetter (1958) in Philadelphia. Generally lower figures have been reported from Great Britain: e.g. 15 3 per cent. by Whittington (1951) and 5-8 per cent. by Lanceley (1953). The wide variation of incidence prompts the suggestion that a significant proportion of NGU cases may be associated with T. vaginalis but that existing diagnostic methods may be inadequate for the detection of this organism. Certainly, in those cases of NGU in which T. vaginalis is found, the parasite can be removed by Metronidazole given orally. Durel, Roiron, and others (1960) had success in all of thirteen male cases (although there was some persistence of the discharge in three cases and one relapse which was