What is the treatment for trichomoniasis (trichomonas infection)?

From the Guidelines

Trichomoniasis is treated with oral metronidazole, with the standard treatment being metronidazole 500 mg orally twice daily for 7 days, or alternatively, a single 2-gram dose of metronidazole taken once, as recommended by the Centers for Disease Control and Prevention 1. The treatment of trichomoniasis is crucial to prevent complications and reduce transmission.

• The recommended metronidazole regimens have resulted in cure rates of approximately 90%-95% 1.
• Ensuring treatment of sex partners might increase the cure rate, and treatment of patients and sex partners results in relief of symptoms, microbiologic cure, and reduction of transmission 1.
• Metronidazole gel is not recommended for use due to its lower efficacy compared to oral preparations of metronidazole 1.
• For pregnant women, treatment is still recommended as the infection can lead to pregnancy complications, though a 7-day course of metronidazole is preferred over single-dose therapy 1.
• Patients should abstain from alcohol during treatment and for 24 hours after taking metronidazole due to potential disulfiram-like reactions (nausea, vomiting, headache).
• Sexual activity should be avoided until both partners complete treatment and symptoms resolve, typically about a week.
• Follow-up testing is generally not necessary if symptoms resolve, but recurrence rates can be 15-20%, often due to reinfection rather than treatment failure.

From the FDA Drug Label

Tinidazole is indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis. The organism should be identified by appropriate diagnostic procedures. Because trichomoniasis is a sexually transmitted disease with potentially serious sequelae, partners of infected patients should be treated simultaneously in order to prevent re-infection

The treatment for trichomoniasis is Tinidazole. The recommended dose is a 2 g single oral dose.

• Key points:
  • Treat partners simultaneously to prevent re-infection
  • Identify the organism by appropriate diagnostic procedures
  • Tinidazole has been shown to be effective in treating trichomoniasis, with reported cure rates ranging from 80% to 100% 2 2

From the Research

Treatment Options for Trichomoniasis

• The standard treatment for trichomoniasis is a single 2-g oral dose of metronidazole 3, 4, 5, 6.
• However, a 7-day dose of metronidazole (500 mg twice daily) has been shown to be more effective than a single dose in some studies 3.
• Tinidazole is another accepted treatment for trichomoniasis, with a cure rate similar to metronidazole 5.
• Intravaginal metronidazole/miconazole has also been studied as a potential treatment, with promising results 7.

Administration and Efficacy

• Oral metronidazole is the most commonly used treatment for trichomoniasis, with a high efficacy rate 3, 4, 5, 6.
• The 7-day dose of metronidazole has been shown to have a higher cure rate than the single dose, especially in cases where bacterial vaginosis is present 3.
• Intravaginal metronidazole/miconazole may offer a well-tolerated alternative to oral metronidazole, with fewer systemic side effects 7.

Side Effects and Considerations

• Metronidazole can cause gastrointestinal side effects, such as nausea and vomiting 3, 7.
• Tinidazole has been shown to have a similar side effect profile to metronidazole 5.
• The choice of treatment should be based on the individual patient's needs and medical history, as well as the severity of the infection 3, 4, 6.