Treatment options for trichomoniasis

Initial measures

Metronidazole (Flagyl, Protostat), 2 g PO in a single dose, or metronidazole, 500 mg PO bid X 7 days, or metronidazole, 375 mg PO bid X 7 days Treat male sexual partners

Measures for treatment failure

Treatment sexual contacts

Re-treat with metronidazole, 500 mg PO bid X 7 days

If infection persists, confirm with culture and re-treat with metronidazole,

3. Pregnancy. Metronidazole is the drug of choice in pregnancy. Metronidazole 500 mg twice daily for 5-7 days is preferred to the 2 g single-dose regimen, but both regimens are acceptable. Treatment of asymptomatic infections is not recommended during pregnancy because it does not prevent preterm delivery.

4. Refractory cases. If treatment failure occurs, retreatment with metronidazole (500 mg PO twice a day for seven days) is recommended. If treatment failure recurs again, the woman should be treated with a single oral 2 g dose of oral metronidazole daily for 3-5 days.

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