From the Guidelines
The recommended treatment for men with trichomoniasis is metronidazole, as it has resulted in cure rates of approximately 90%-95% in randomized clinical trials. This treatment is based on the guidelines from the Centers for Disease Control and Prevention, as reported in the study 1. The study found that metronidazole is the only oral medication available in the United States for the treatment of trichomoniasis, and it is approved by the FDA for this purpose. Some key points to consider when treating men with trichomoniasis include:
- Ensuring treatment of sex partners to increase the cure rate
- Using oral preparations of metronidazole, as they are more efficacious than topically applied antimicrobials
- Avoiding the use of metronidazole gel, as it is less efficacious for treatment of trichomoniasis
- Considering the potential for relief of symptoms, microbiologic cure, and reduction of transmission with treatment. It's worth noting that an earlier study 1 also supports the use of metronidazole for the treatment of trichomoniasis, but the more recent study 1 provides the most up-to-date guidance.
From the FDA Drug Label
Metronidazole tablets are indicated for the treatment of symptomatic trichomoniasis in females and males when the presence of the trichomonad has been confirmed by appropriate laboratory procedures (wet smears and/or cultures) T. vaginalis infection is a venereal disease. Therefore, asymptomatic sexual partners of treated patients should be treated simultaneously if the organism has been found to be present, in order to prevent reinfection of the partner The decision as to whether to treat an asymptomatic male partner who has a negative culture or one for whom no culture has been attempted is an individual one. In any event, the consort should be treated with metronidazole tablets in cases of reinfection
- Treatment for men with trichomoniasis: Metronidazole tablets are indicated for the treatment of symptomatic trichomoniasis in males.
- Key points:
- The presence of the trichomonad should be confirmed by laboratory procedures.
- Asymptomatic male partners should be treated simultaneously to prevent reinfection.
- The decision to treat an asymptomatic male partner with a negative culture is individual.
- Metronidazole tablets should be used to treat the consort in cases of reinfection 2
- Alternative treatment: Tinidazole is also indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis 3, 3
From the Research
Treatment Options for Men with Trichomoniasis
- The preferred treatment for men with trichomoniasis is a 2-g single-dose oral metronidazole regimen 4.
- Secnidazole is also an effective treatment option for men with trichomoniasis, with a single 2-g dose or a 3-day course showing comparable efficacy to multi-dose metronidazole 5.
- Tinidazole is another accepted treatment for trichomoniasis, with a 2-g single dose being as effective as a 2-g single dose of metronidazole 6.
Efficacy of Treatment Options
- The cure rate for tinidazole is 95% 6, while the cure rate for metronidazole is 97.5% 6 and 93.8% 7.
- Secnidazole has a microbiologic cure rate of 92.2% in a single 2-g dose 5.
- A 7-day course of metronidazole has a cure rate of 97.3% 7.
Comparison of Treatment Options
- A single 2-g dose of metronidazole is recommended due to its easy administration, better patient compliance, and lower cost 7.
- Secnidazole has a favorable pharmacokinetic profile and is generally well tolerated by patients 5.
- Tinidazole is effective in treating metronidazole-resistant vaginal trichomoniasis, with a cure rate of 92% 8.