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Trichomonas vaginalis infection

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Updated 2024 WHO guidelines for the treatment of Trichomonas vaginalis infection.

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of Trichomonas vaginalis infection are prepared by our editorial team based on guidelines from the World Health Organization (WHO 2024), the Center for Disease Control (CDC 2021), the American College of Obstetricians and Gynecologists (ACOG 2020), the International Union Against Sexually Transmitted Infections (IUSTI/WHO 2018), and the Society of Obstetricians and ...
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Diagnostic investigations

Initial evaluation: as per IUSTI/WHO 2018 guidelines, obtain nucleic amplification tests for the diagnosis of Trichomonas vaginalis.
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Medical management

Antibiotic therapy
As per WHO 2024 guidelines:
Consider administering metronidazole 400 mg or 500 mg PO BID for 7 days in adult and adolescent patients (including pregnant women) with Trichomonas vaginalis infection.
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Consider administering any of the following options if adherence to multiple doses is a serious concern:
metronidazole 2 g PO as a single dose
tinidazole 2 g PO as a single dose (except during pregnancy)
secnidazole 2 g PO as a single dose (except during pregnancy) or ornidazole 1.5 g PO as a single dose (except during pregnancy) if metronidazole or tinidazole is not available
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More topics in this section

  • Management of persistent/recurrent disease

  • Management of sexual partners

Specific circumstances

Pregnant patients: as per IUSTI/WHO 2018 guidelines, administer metronidazole for the treatment of trichomoniasis in pregnant patients.
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  • Patients with HIV

Follow-up and surveillance

Post-treatment testing: as per SOGC 2015 guidelines, do not obtain tests of cure following treatment of trichomoniasis with oral metronidazole.
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