What is the treatment of choice for trichomoniasis?

Updated: Jan 02, 2020
  • Author: Darvin Scott Smith, MD, MSc, DTM&H; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The CDC recommends two oral nitroimidazoles for the treatment of trichomoniasis: metronidazole (Flagyl) and tinidazole (Tindamax). [11] Although generally more expensive, tinidazole is associated with fewer adverse effects than metronidazole and is equal or superior in resolving T vaginalis infection. When the first-line agent is ineffective (and reinfection by partner is ruled out), the other nitroimidazole or an alternative dosing schedule of metronidazole may be used. Topical metronidazole and other antimicrobials are not efficacious and should not be used to treat trichomoniasis.

Sexual partners of the infected patient should also be treated. [11] Both the patient and partners should abstain from sexual activity until pharmacological treatment has been completed and they have no symptoms. In regions where expedited partner therapy (EPT) is legal, it may be useful in managing trichomoniasis. [14] Infected women who are sexually active have a high rate of reinfection; thus, rescreening at 3 months posttreatment should be considered. [11] Currently, data are insufficient to support rescreening men.


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