Trichomoniasis Health Article

Allopathic treatment

The usual treatment is a single large dose of metronidazole (Flagyl) or split doses over the course of a week. Some sources suggest clotrimazole (Gyne-lotrimin, Mycelex) as an alternative treatment showing a lower cure rate. Application of Betadine, a concentrated antiseptic solution, is another recommendation, although Betadine is messy, stains, and should not be used by pregnant women. However, the Centers for Disease Control (CDC) states that there are no effective alternatives to therapy with metronidazole available. Topical treatment with metronidazole is not advised. Individual evaluations are recommended for those who are allergic to metronidazole or who experience treatment-resistant trichomoniasis. Sexual partners of an infected individual must all be treated, to prevent the infection from being passed back and forth. Sexual intercourse should be avoided until all partners are cured.

As of late 2003, the number of cases of metronidazole-resistant trichomoniasis appears to be increasing rapidly. Some success has been reported with the broad-spectrum anti-parasitic drug nitazoxanide, but further research needs to be done. A group of researchers in Thailand is currently investigating the effectiveness of a group of drugs known as bisquaternary quinolinium salt compounds in treating trichomoniasis.

Women who are taking antibiotics for other illnesses should speak to their health care provider about the possibile effects of the medication(s) on the balance of organisms in their vagina.

Expected results

Prognosis is excellent (90–95%) with appropriate treatment of the patient and all sexual partners. Without treatment, the infection can remain for a long time, and can be passed to all sexual partners.

Prevention

All sexually transmitted diseases can be prevented by using adequate protection during sexual intercourse. Effective forms of protection include male and female condoms. Other preventive measures are similar to those for other forms of vaginitis, including wearing loose cotton clothing and not using douches, vaginal deodorants, or sprays.

BOOKS

Nash, Theodore E., and Peter F. Weller. "Protozoal Intestinal Infections and Trichomoniasis." Harrison's Principles of Internal Medicine, 14th ed. Edited by Anthony S. Fauci, et al. New York: McGraw-Hill, 1998.

Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part II, "CAM Therapies for Specific Conditions: Vaginitis." New York: Simon & Schuster, 2002.

Plorde, James J. "Introduction to Pathogenic Parasites: Pathogenesis and Chemotherapy of Parasitic Diseases." Sherris Medical Microbiology: An Introduction to Infectious Diseases. Edited by Kenneth J. Ryan. Norwalk, CT: Appleton and Lange, 1994.

Rosenthal, M. Sara. The Gynecological Sourcebook. Los Angeles, Lowell House. 1994.

PERIODICALS

Chavalitshewinkoon-Petmitr, P., M. Ramdja, S. Kajorndechakiat, et al. "In vitro Susceptibility of Trichomonas vaginalis to AT-Specific Minor Groove Binding Drugs" Journal of Antimicrobial Chemotherapy 52 (August 2003): 287–289.

Ching, Susanne, and Phuong H. Nguyen. "Vaginitis." eMedicine, 5 April 2002. <http://emedicine.com/med/topic2358.htm>.

Davis, Annabel. "Trichomonas vaginalis: Signs, Tests, and Treatment." Nursing Times 94 (November 25-December 1, 1998): 58-59.

Dunne, R. L., L. A. Dunn, P. Upcroft, et al. "Drug Resistance in the Sexually Transmitted Protozoan Trichomonas vaginalis." Cell Research 13 (August 2003): 239–249.

Pirotta, M. V., J. M. Gunn, and P. Chondros. "'Not Thrush Again!' Women's Experience of Post-Antibiotic Vulvovaginitis." Medical Journal of Australia 179 (July 7, 2003): 47–49.

Schwebke, J. R., and E. W. Hook, 3rd. "High Rates of Trichomonas vaginalis Among Men Attending a Sexually Transmitted Diseases Clinic: Implications for Screening and Urethritis Management." Journal of Infectious Diseases 188 (August 1, 2003): 465–468.

OTHER

Centers for Disease Control and Prevention (CDC). "Fact Sheet: Trichomonas Infection. <http://www.cdc.gov/ncidod/dpd/parasites/trichomonas/factsht_trichomonas.htm>.

Kathy S. Stolley

Rebecca J. Frey, PhD