From the Guidelines
Trichomonas infection is treated with oral metronidazole or tinidazole, with the standard treatment being metronidazole 500 mg orally twice daily for 7 days, or alternatively, a single 2-gram dose of metronidazole, as recommended by the most recent guidelines 1. The treatment of trichomoniasis is crucial to relieve symptoms, achieve microbiologic cure, and reduce transmission.
- The recommended regimens have resulted in cure rates of approximately 90-95%, which might increase if the treatment of sex partners is ensured 1.
- Metronidazole gel is not recommended for the treatment of trichomoniasis due to its lower efficacy compared to oral preparations 1.
- Patients should be instructed to avoid sex until they and their sex partners are cured, and to abstain from alcohol consumption during treatment to avoid a disulfiram-like reaction with metronidazole or tinidazole.
- For pregnant women, metronidazole is safe to use in all trimesters, but if symptoms persist after treatment, a follow-up evaluation is necessary to rule out reinfection or drug resistance 1.
- In rare cases of resistant infection, higher doses or longer treatment courses may be needed, and treatment of sex partners is essential to prevent reinfection.
From the FDA Drug Label
1 INDICATIONS AND USAGE
- 1 Trichomoniasis Tinidazole is indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis.
14 CLINICAL STUDIES
- 1 Trichomoniasis 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 In four published, blinded, randomized, comparative studies of the 2 g tinidazole single oral dose where efficacy was assessed by culture at time points post-treatment ranging from one week to one month, reported cure rates ranged from 92% (37/40) to 100% (65/65) (n=172 total subjects)
The treatment for trichomoniasis is Tinidazole with a single oral dose of 2 g. The cure rates for this treatment range from 92% to 100% 2.
- Tinidazole is indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis 2.
- Another option for the treatment of trichomoniasis is Metronidazole 3.
From the Research
Treatment Options for Trichomonas
- Metronidazole is a commonly used treatment for trichomoniasis, with a single-dose regimen being compared to a 7-day dose regimen in several studies 4, 5.
- The 7-day dose regimen of metronidazole has been shown to be more effective than the single-dose regimen in some studies, with a lower rate of treatment failure 4.
- Tinidazole is another treatment option for trichomoniasis, with a single dose of 2g being recommended for treatment 6.
- Tinidazole has been shown to be as effective as metronidazole in treating trichomoniasis, and may be more effective in treating giardiasis and amebiasis 6.
Resistant Trichomoniasis
- Resistant trichomoniasis is a growing public health concern, with implications for long-term health consequences 7.
- High-dose regimens of metronidazole or tinidazole may be effective in treating resistant trichomoniasis, as well as alternative treatment options such as intravaginal paromomycin cream and boric acid 7.
- In vitro testing of Trichomonas vaginalis drug susceptibility has identified minimal lethal concentrations for metronidazole and tinidazole that correspond with treatment failure, which can help guide appropriate patient treatment 8.
Treatment Efficacy and Side Effects
- The efficacy and side effects of different treatment regimens for trichomoniasis have been compared in several studies, with the 7-day dose regimen of metronidazole being shown to be more effective than the single-dose regimen in some studies 4, 5.
- The most common side effects of metronidazole and tinidazole include nausea, abdominal discomfort, and vomiting 4, 6.
- Self-reported adherence to treatment regimens has been shown to be high, with over 95% of patients reporting adherence to the 7-day dose regimen of metronidazole 4.