Trichomoniasis medical therapy
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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
Trichomoniasis can usually be cured with the prescription drug, metronidazole, given by mouth in a single dose. The symptoms of trichomoniasis in infected men may disappear within a few weeks without treatment. However, an infected man, even a man who has never had symptoms or whose symptoms have stopped, can continue to infect or re-infect a female partner until he has been treated. Therefore, both partners should be treated at the same time to eliminate the parasite. Persons being treated for trichomoniasis should avoid sex until they and their sex partners complete treatment and have no symptoms. Metronidazole can be used by pregnant women. Having trichomoniasis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.
Medical Therapy
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
- 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
- Preferred regimen: Metronidazole 500 mg PO bid for 7 days
- 4.2 Treatment failure again
- Preferred regimen (1): Metronidazole 2 g PO for 7 days
- Preferred regimen (2): Tinidazole 2 g PO for 7 days
- 4.3 Nitroimidazole-resistant cases
- Preferred regimen: Ti nidazole 2-3 g PO for 14 days