Excerpt from The WHO Reproductive Health Library Published by Update Software Ltd.

Trichomoniasis treatment in women

Short treatment regimens with drugs of the nitroimidazole class are as effective as the longer treatment regimens. Among varying nitroimidazole drugs available for the therapy of trichomoniasis, tinidazole was more effective than metronidazole. Identifying women infected with trichomoniasis is often more difficult than treating them.

RHL Commentary by George Schmid

EVIDENCE SUMMARY

This review compares the efficacy of various strategies for the treatment of trichomoniasis in women, in particular, short versus long oral treatment regimens. Short treatment regimens with drugs of the nitroimidazole class (mostly given as a single dose) are as effective in achieving success as longer treatment regimens (of at least five days’ duration) (RR 1.12, 95% CI, 0.58-2.16); therapy with any regimen is generally >90%. Failure to treat partners may lead to apparent lack of therapeutic success and, because trichomoniasis is a sexually transmitted infection (STI), treatment of male partners must be part of the treatment regimen of infected women. The only trial that compared treatment outcome among women whose partners were not treated vs. those who were treated showed that women whose partners were not treated had a significantly higher failure rate (24% vs. 5%). Among varying nitroimidazole drugs available for the therapy of trichomoniasis, tinidazole was more effective than metronidazole, although the quality of the studies comparing the two drugs was not optimal.

All adequately controlled trials which could be identified have been included and appropriately analysed.

The full RHL commentary also includes sections on:

Relevance
- Magnitude of the problem
- Applicability of the results
- Implementation of the intervention
Research
References

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This document should be cited as: George Schmid. Trichomoniasis treatment in women: RHL commentary (last revised: 28 July 2003). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com