Trichomoniasis medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
Antimicrobial therapy is indicated in trichomoniasis. | Antimicrobial therapy is indicated in trichomoniasis among both genders when the diagnosis is confirmed. The symptoms of trichomoniasis among infected men may disappear within a few weeks even without treatment, but asymptomatic men may continue to be infectious and should therefore be treated. Antimicrobial therapy generally includes either [[metronidazole]] or [[tinidazole]] 2 g PO in a single dose. Prolonged therapy for 7 days is indicated among patients who fail the initial course of therapy. Following successful treatment, individuals may still be susceptible to re-infection. | ||
==Medical Therapy== | ==Medical Therapy== | ||
*Antimicrobial therapy is indicated in trichomoniasis among both genders when the diagnosis is confirmed. | |||
*The symptoms of trichomoniasis among infected men may disappear within a few weeks even without treatment, but asymptomatic men may continue to be infectious and should therefore be treated. | |||
===Antimicrobial Regimen=== | ===Antimicrobial Regimen=== | ||
:* 1. '''T. vaginalis infection in adults'''<ref>{{cite web | title =trichomoniasis | url = http://www.cdc.gov/std/tg2015/trichomoniasis.htm }}</ref> | :* 1. '''''T. vaginalis'' infection in adults'''<ref>{{cite web | title =trichomoniasis | url = http://www.cdc.gov/std/tg2015/trichomoniasis.htm }}</ref> | ||
::* Preferred regimen (1): [[Metronidazole]] 2 g PO in a single dose | ::* Preferred regimen (1): [[Metronidazole]] 2 g PO in a single dose | ||
::* Preferred regimen (2): [[Tinidazole]] 2 g PO in a single dose | ::* Preferred regimen (2): [[Tinidazole]] 2 g PO in a single dose | ||
::* Alternative regimen: [[Metronidazole]] 500 mg PO bid for 7 days | ::* Alternative regimen: [[Metronidazole]] 500 mg PO bid for 7 days | ||
:* 2. '''T. vaginalis infection in pregnant and lactating Women''' | ::*Note: Patients should avoid sexual contact until they are fully cured of trichomoniasis | ||
:* 2. '''''T. vaginalis'' infection in pregnant and lactating Women''' | |||
::* 2.1 '''Pregnant women''' | ::* 2.1 '''Pregnant women''' | ||
:::* Preferred regimen: [[Metronidazole]] 2 g PO in a single dose | :::* Preferred regimen: [[Metronidazole]] 2 g PO in a single dose | ||
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:::* Note (2): Symptomatic pregnant women, regardless of pregnancy stage, should be tested and considered for treatment. Pregnant women should be advised of the risk and benefits to treatment as infection (definitely) and treatment (possibly) | :::* Note (2): Symptomatic pregnant women, regardless of pregnancy stage, should be tested and considered for treatment. Pregnant women should be advised of the risk and benefits to treatment as infection (definitely) and treatment (possibly) | ||
:::* Note (3): Pregnant women with HIV who are treated for T. vaginalis infection should be retested 3 months after treatment. | :::* Note (3): Pregnant women with HIV who are treated for T. vaginalis infection should be retested 3 months after treatment. | ||
:* 3. '''T. vaginalis infection in patients with HIV''' | :* 3. '''''T. vaginalis'' infection in patients with HIV''' | ||
::* Preferred regimen: [[Metronidazole]] 500 mg PO bid for 7 days | ::* Preferred regimen: [[Metronidazole]] 500 mg PO bid for 7 days | ||
:* 4. '''Persistent or recurrent trichomoniasis''' | :* 4. '''Persistent or recurrent trichomoniasis''' | ||
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:::* Preferred regimen (1): [[Metronidazole]] 2 g PO for 7 days | :::* Preferred regimen (1): [[Metronidazole]] 2 g PO for 7 days | ||
:::* Preferred regimen (2): [[Tinidazole]] 2 g PO for 7 days | :::* Preferred regimen (2): [[Tinidazole]] 2 g PO for 7 days | ||
::* 4.3 '''Nitroimidazole-resistant | ::* 4.3 '''Nitroimidazole-resistant ''T. vaginalis''''' | ||
:::* Preferred regimen: [[Tinidazole]] 2-3 g PO for 14 days | :::* Preferred regimen: [[Tinidazole]] 2-3 g PO for 14 days | ||
===Treatment of Sexual Partners=== | |||
*Sexual partners of patients with trichomoniasis should also be evaluated and treated. | |||
*Patients and their sexual partners should avoid sexual contact until they are fully cured of trichomoniasis. | |||
===Follow-up=== | |||
*Patients should be re-evaluated at the end of the antimicrobial therapy regimen to evaluate for cure vs. failure of therapy. | |||
*Patients should be instructed that they are still susceptible to re-infection. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 15:36, 6 October 2015
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Risk calculators and risk factors for Trichomoniasis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Antimicrobial therapy is indicated in trichomoniasis among both genders when the diagnosis is confirmed. The symptoms of trichomoniasis among infected men may disappear within a few weeks even without treatment, but asymptomatic men may continue to be infectious and should therefore be treated. Antimicrobial therapy generally includes either metronidazole or tinidazole 2 g PO in a single dose. Prolonged therapy for 7 days is indicated among patients who fail the initial course of therapy. Following successful treatment, individuals may still be susceptible to re-infection.
Medical Therapy
- Antimicrobial therapy is indicated in trichomoniasis among both genders when the diagnosis is confirmed.
- The symptoms of trichomoniasis among infected men may disappear within a few weeks even without treatment, but asymptomatic men may continue to be infectious and should therefore be treated.
Antimicrobial Regimen
- 1. T. vaginalis infection in adults[1]
- Preferred regimen (1): Metronidazole 2 g PO in a single dose
- Preferred regimen (2): Tinidazole 2 g PO in a single dose
- Alternative regimen: Metronidazole 500 mg PO bid for 7 days
- Note: Patients should avoid sexual contact until they are fully cured of trichomoniasis
- 2. T. vaginalis infection in pregnant and lactating Women
- 2.1 Pregnant women
- Preferred regimen: Metronidazole 2 g PO in a single dose
- 2.2 Post-partum and Breastfeeding
- Preferred regimen (1): Metronidazole 2 g PO in a single dose
- Preferred regimen (2): Tinidazole 2 g PO in a single dose
- Note (1): Do not breastfeed for 12-24 hrs following Metronidazole and 72 hrs following Tinidazole
- Note (2): Symptomatic pregnant women, regardless of pregnancy stage, should be tested and considered for treatment. Pregnant women should be advised of the risk and benefits to treatment as infection (definitely) and treatment (possibly)
- Note (3): Pregnant women with HIV who are treated for T. vaginalis infection should be retested 3 months after treatment.
- 3. T. vaginalis infection in patients with HIV
- Preferred regimen: Metronidazole 500 mg PO bid for 7 days
- 4. Persistent or recurrent trichomoniasis
- 4.1 Treatment failure, first-time
- Preferred regimen: Metronidazole 500 mg PO bid for 7 days
- 4.2 Treatment failure, second-time
- Preferred regimen (1): Metronidazole 2 g PO for 7 days
- Preferred regimen (2): Tinidazole 2 g PO for 7 days
- 4.3 Nitroimidazole-resistant T. vaginalis
- Preferred regimen: Tinidazole 2-3 g PO for 14 days
Treatment of Sexual Partners
- Sexual partners of patients with trichomoniasis should also be evaluated and treated.
- Patients and their sexual partners should avoid sexual contact until they are fully cured of trichomoniasis.
Follow-up
- Patients should be re-evaluated at the end of the antimicrobial therapy regimen to evaluate for cure vs. failure of therapy.
- Patients should be instructed that they are still susceptible to re-infection.