Does a partner of a patient with Trichomonas (Trichomonas vaginalis) infection need to be treated?

From the Guidelines

Yes, when a person is diagnosed with a Trichomonas infection (trichomoniasis), their sexual partner(s) should also be treated, even if they don't have symptoms, as this approach has been shown to increase cure rates and reduce transmission 1. The standard treatment for both the infected person and their partner(s) is metronidazole 2 grams as a single oral dose, or alternatively, tinidazole 2 grams as a single oral dose. If the single-dose regimen isn't feasible, metronidazole 500 mg twice daily for 7 days is an effective alternative.

Key Considerations

• Both partners should abstain from sexual intercourse until they have completed treatment and are symptom-free, typically for about a week after finishing medication.
• Partner treatment is essential because trichomoniasis can be easily passed back and forth between sexual partners (ping-pong infection), leading to reinfection if only one person is treated.
• Even asymptomatic partners can harbor the Trichomonas vaginalis parasite and transmit it during sexual contact.
• Treating both partners simultaneously breaks the cycle of reinfection and increases the likelihood of complete cure for both individuals, as supported by the findings of the Centers for Disease Control and Prevention guidelines 1.

Treatment Efficacy

• The recommended metronidazole regimens have resulted in cure rates of approximately 90%-95% 1.
• Metronidazole gel is not recommended for the treatment of trichomoniasis due to its lower efficacy compared to oral preparations of metronidazole 1.

From the FDA Drug Label

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 [see Clinical Studies ( 14. 1)]. 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

Yes, a partner of a patient with Trichomonas (Trichomonas vaginalis) infection should be treated to prevent re-infection, as stated in the drug labels for tinidazole 2 and metronidazole 3.

• The treatment of partners is necessary to prevent reinfection.
• Asymptomatic partners should be treated if the organism is present.

From the Research

Treatment of Trichomonas Infection

• The treatment of Trichomonas vaginalis infection typically involves the use of metronidazole, with a recommended dose of 2-g oral single-dose or 7-day dose of 500 mg twice daily 4, 5.
• However, the efficacy of metronidazole can be affected by factors such as antibiotic resistance, with studies showing that alternative 5-nitroimidazole drugs like tinidazole, ornidazole, and secnidazole may be effective against metronidazole-resistant T. vaginalis isolates 6.

Partner Treatment

• Partner treatment is essential in the management of Trichomonas vaginalis infection, as up to 70% of male sexual partners can be infected 4.
• Expedited partner treatment is recommended, especially given the high rates of repeat infections among women 5.
• The treatment of partners can help prevent reinfection and reduce the risk of transmission to others.

Management of Refractory Infection

• In cases of refractory vaginal trichomoniasis, where initial metronidazole treatment fails, alternative treatment strategies may be necessary 7.
• The use of combination therapy, such as oral and vaginal tinidazole, or alternative 5-nitroimidazole drugs, may be effective in treating refractory infections 7.
• The possibility of metronidazole-resistant T. vaginalis should be considered in cases of treatment failure, and resistance testing may be necessary to guide treatment decisions.