From the Guidelines
No, Bicillin (penicillin G benzathine) and doxycycline are not effective treatments for trichomoniasis. The most recent and highest quality study, 1, recommends metronidazole or tinidazole as the first-line treatment for trichomoniasis.
Treatment Options
- Metronidazole 500 mg orally twice daily for 7 days
- Metronidazole 2 grams as a single oral dose
- Tinidazole 2 grams as a single oral dose These medications work by disrupting the DNA synthesis of the Trichomonas vaginalis parasite, which causes the infection. It's essential to treat all sexual partners simultaneously to prevent reinfection, and to abstain from sexual activity until both partners have completed treatment and symptoms have resolved. If you suspect trichomoniasis, you should seek proper diagnosis through testing before starting treatment, as symptoms can be similar to other sexually transmitted infections. Metronidazole and tinidazole may cause side effects, including nausea and metallic taste, and should not be combined with alcohol due to potential disulfiram-like reactions. According to 1, metronidazole has resulted in cure rates of approximately 90%--95%, making it the most effective treatment option.
From the Research
Treatment Options for Trichomonas
- Metronidazole is the first-line treatment for trichomoniasis, with a single dose or 7-day dose regimen being effective 2.
- However, metronidazole-resistant trichomoniasis can be challenging to treat, and alternative options are needed.
- A combination regimen consisting of high-dose tinidazole plus a broad-spectrum antibiotic, such as doxycycline, and clotrimazole pessaries, has been shown to be effective in treating metronidazole-resistant trichomoniasis 3.
- Doxycycline has been used in combination with tinidazole to treat metronidazole-resistant trichomoniasis, but its effectiveness as a single agent is not well established.
- Bicillin is not mentioned in the provided studies as a treatment option for trichomoniasis.
- Tinidazole has been shown to be effective in treating metronidazole-refractory vaginal trichomoniasis, with a cure rate of 92% in one study 4.
Limitations of Current Treatments
- Metronidazole treatment failure can range from 7-10%, and even higher among HIV-positive women 5.
- The origins of repeat positives after metronidazole treatment are not well understood and require further explanation 5.
- There is a need for additional trichomonacidal agents to address the limitations of current treatments 4.