What is the treatment for Trichomoniasis (Trichomonas infection)?

From the Guidelines

Trichomoniasis should be treated with metronidazole, which is the only FDA-approved drug for this condition, with a recommended regimen of 500 mg orally twice daily for 7 days or a single 2-gram dose, resulting in cure rates of approximately 90%--95%. The treatment of Trichomoniasis is primarily focused on relieving symptoms, achieving microbiologic cure, and reducing transmission 1. The nitroimidazoles, specifically metronidazole, are the only class of drugs useful for the oral or parenteral therapy of trichomoniasis 1. Key points to consider in the treatment of Trichomoniasis include:

• Metronidazole is the preferred treatment due to its high efficacy and FDA approval 1
• The recommended metronidazole regimens have resulted in cure rates of approximately 90%--95% 1
• Ensuring treatment of sex partners might increase the cure rate 1
• Topically applied antimicrobials, such as metronidazole gel, are less efficacious for treatment of trichomoniasis and not recommended 1
• Treatment of patients and sex partners results in relief of symptoms, microbiologic cure, and reduction of transmission 1

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) Tinidazole is indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis. The organism should be identified by appropriate diagnostic procedures. Tinidazole (2 g single oral dose) use in trichomoniasis has been well documented in 34 published reports from the world literature involving over 2,800 patients treated with tinidazole

The treatment for Trichomoniasis (Trichomonas infection) is:

• Metronidazole tablets
• Tinidazole (2 g single oral dose) Both treatments are indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis, and the organism should be identified by appropriate diagnostic procedures 2, 3, 3.

From the Research

Treatment Options for Trichomoniasis

• The first-line treatment for trichomoniasis is metronidazole, with a single dose of 2 g being the standard treatment 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 clearing the infection 4.
• Tinidazole is another accepted treatment for trichomoniasis, with a single dose of 2 g being as effective as a single dose of metronidazole 5.
• Intravaginal metronidazole/miconazole has also been studied as a treatment option, with results showing no significant differences in cure rates compared to oral metronidazole 7.

Considerations for Treatment

• Bacterial vaginosis can alter treatment efficacy in HIV-infected women, and single-dose metronidazole treatment might not always clear the infection 4.
• Metronidazole resistance is an emerging problem, but its clinical importance is not yet clear 8, 6.
• Concomitant treatment of sexual partners is recommended to prevent reinfection 6.

Side Effects and Adherence

• Common side effects of metronidazole include nausea, headache, and vomiting 4.
• Self-reported adherence to the 7-day dose of metronidazole was 96%, compared to 99% for the single dose 4.
• Intravaginal metronidazole/miconazole may offer a well-tolerated treatment option that avoids the systemic adverse effects of nitroimidazoles 7.