From the Guidelines
The recommended treatment for trichomoniasis is a single dose of metronidazole 2 grams orally, or tinidazole 2 grams orally 1. Alternatively, metronidazole can be taken at a dose of 500 mg twice a day for 7 days 1. It is essential to treat both sexual partners simultaneously to prevent reinfection.
Key Considerations
- Pregnant women can be treated with metronidazole, but the single dose regimen is not recommended; instead, a 7-day course of 500 mg twice a day is preferred 1.
- Metronidazole use during pregnancy has not been shown to have a consistent association with teratogenic or mutagenic effects in the infant 1.
- Infections with strains that show diminished susceptibility to metronidazole can occur, and pregnant women should be managed in consultation with an expert in infectious diseases 1.
Treatment Options
- Metronidazole: 2 grams orally as a single dose, or 500 mg twice a day for 7 days 1.
- Tinidazole: 2 grams orally as a single dose 1.
From the FDA Drug Label
Tinidazole is indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis. 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)
The treatment for trichomoniasis is Tinidazole or Metronidazole.
- Tinidazole is indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis 2.
- Metronidazole is 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) 3. Partners of infected patients should be treated simultaneously to prevent re-infection.
From the Research
Treatment Options for Trichomoniasis
- The first-line treatment for trichomoniasis is metronidazole, with a single dose of 2g being the traditional recommendation 4, 5.
- However, recent studies have shown that a 7-day dose of metronidazole (500mg twice daily) is nearly two times more efficacious at clearing infection compared to the single 2g dose 4, 6.
- Tinidazole is another accepted treatment for trichomoniasis, with a single dose of 2g being as effective as metronidazole 7.
- Intravaginal metronidazole/miconazole has also been studied as a potential treatment, with cure rates comparable to oral metronidazole 8.
- Partner treatment is essential, as up to 70% of male sexual partners can be infected, and rescreening of treated women at 3 months is recommended due to high repeat infection rates 6.
Treatment Efficacy and Side Effects
- The efficacy of metronidazole treatment can be affected by bacterial vaginosis, but the 7-day dose regimen has been shown to be effective regardless of bacterial vaginosis status 4.
- Side effects of metronidazole treatment are generally minimal, but can include nausea, headache, and vomiting 4, 5.
- Intravaginal metronidazole/miconazole may offer a well-tolerated treatment option that avoids the systemic adverse effects of nitroimidazoles 8.