Trichomoniasis Treatment and Care
Trichomoniasis is treatable.
How should healthcare providers treat trichomoniasis?
The recommended first-line treatment for trichomoniasis is metronidazole. Treatment reduces symptoms and signs of trichomoniasis and might reduce transmission. Healthcare providers should advise people with trichomoniasis to not have sex again until they and their sex partners are treated (when therapy has been completed and any symptoms have resolved). Because of the high rate of reinfection among women treated for trichomoniasis, retesting for trichomoniasis is recommended approximately 3 months after initial treatment for all sexually active women.
What if a patient has recurrent or persistent trichomoniasis?
Healthcare providers with patients experiencing persistent infection after completing recommended treatment for trichomoniasis can consult with CDC for T. vaginalis drug susceptibility testing and additional treatment options. Request specimen collection materials and submission approval from the CDC lab for T. vaginalis susceptibility testing. For clinical guidance with the management of recurrent or persistent trichomoniasis, healthcare providers can contact the CDC Trichomonas Clinical Consultation Team.
What if a patient has a reported drug allergy to metronidazole?
Recommended first-line (metronidazole) and alternative treatment (tinidazole) for trichomoniasis are nitroimidazoles. Patients with an IgE-mediated-type hypersensitivity reaction to 5-nitroimidazole antimicrobials should be managed by metronidazole desensitization according to published regimens and in consultation with an allergy specialist. For additional clinical guidance with the management of trichomoniasis in the setting of nitroimidazole allergy, you can receive consultation via the STD Clinical Consultation Network. Consults are provided by national experts by phone or email within 1–5 business days, depending on the requestor’s preference.
Treatment Guidelines and Updates
- 2021 STI Treatment Guidelines – Trichomoniasis (July 22, 2021)
Resources for Clinicians
- Vaginitis Self-Study Module – An online learning experience that helps users learn how to manage vaginitis. Free CME/CNE available. (November 1, 2017)
- Advances in Laboratory Detection of Trichomonas vaginalis – from the Association of Public Health Laboratories (APHL)
- Modified Oral Metronidazole Desensitization Protocol – Gendelman SR, et al. Therapeutic Advances in Allergy and Rhinology, 2014.
- Management of Trichomonas vaginalis in women with suspected metronidazole hypersensitivity – Helms DJ, et al. American Journal of Obstetrics and Gynecology, 2008.