Treatment of Trichomoniasis
Standard Treatment Regimens
- The Centers for Disease Control and Prevention recommends metronidazole 2g orally as a single dose, achieving cure rates of approximately 90-95% 1, 2
- The Centers for Disease Control and Prevention recommends metronidazole 2g orally in a single dose as the preferred regimen for both men and women with trichomoniasis 3, 4, 5, 6
- An alternative regimen is metronidazole 500mg orally twice daily for 7 days 3, 4, 5, 6
Management of Treatment Failure
- For first treatment failure, re-treat with metronidazole 500mg twice daily for 7 days 1, 2, 3, 4, 5, 6
- For repeated failure, administer metronidazole 2g once daily for 3-5 days 1, 2, 3, 4, 5, 6
- Consider consultation with an infectious disease specialist for susceptibility testing if reinfection has been excluded 1, 2, 3, 4, 5, 6
Critical Management Principles
- The Centers for Disease Control and Prevention recommends that all sexual partners must be treated simultaneously to prevent reinfection 1, 2, 3, 4, 5, 6
- Patients should abstain from sexual activity until both they and their partners complete treatment and are asymptomatic 1, 2, 3, 4, 5, 6
- Failure to treat partners is the most common cause of recurrent infection 1, 2
Special Populations
- The Centers for Disease Control and Prevention recommends that metronidazole is contraindicated in the first trimester of pregnancy 3, 4, 5
- After the first trimester, treat with metronidazole 2g orally as a single dose 3, 4, 5, 6
- Treatment is important as trichomoniasis is associated with premature rupture of membranes and preterm delivery 3, 4, 5, 6