How is trichomoniasis treated?

Updated: Dec 04, 2018
  • Author: Hetal B Gor, MD, FACOG; Chief Editor: Michel E Rivlin, MD  more...
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Answer

Recommended regimens for T vaginalis infection include the following:

  • Metronidazole 2 g orally in a single dose (or 500 mg orally twice a day for 7 days)

  • Tinidazole 2 g orally in a single dose

Metronidazole is the treatment of choice both for patients who are immunocompetent and for those who are immunocompromised.

Because trichomonads often infect the urethra and the Skene and Bartholin glands, metronidazole gel is considerably less efficacious than an oral preparation; therefore, use of the gel is not recommended. Sex partners of patients with T vaginalis infection should be treated, and intercourse should be avoided until both partners have been treated and are asymptomatic. Pregnant women with trichomoniasis may be treated with 2 g of metronidazole in a single dose.

Lactating women should withhold breastfeeding during treatment and for 12-24 hours after the last dose of metronidazole. For women taking tinidazole, breastfeeding should be interrupted during treatment and for 3 days after the last dose.

Topical treatment with nonoxynol-9 and povidone-iodine douches has been shown to be effective in treating T vaginalis infection in women unable to use metronidazole. Further studies are needed to confirm this preliminary finding.

A vaccine containing killed “aberrant lactobacilli” is available in Europe. This vaccine has not been evaluated in well-controlled, double-blind prospective trials.


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