Fifty-three trials were included in a Cochrane review [Abstract] 1. The trials were small and of variable quality. Almost any nitroimidazole drug given as a single dose or over a longer period resulted in parasitological cure in 90% of cases (nitroimidazoles compared to no treatment, parasitological cure up to two weeks: RR 0.18, 95% CI 0.15 to 0.23; 6 trials, n=672). Oral single dose treatment is associated with more frequent side effects than either longer oral or intravaginal treatment.
Oral treatment with metronidazole was more successful than intravaginal treatment (RR for parasitological cure 0.20, 95% CI 0.07 to 0.56; 2 trials, n=94). Combined oral and intravaginal treatment appears to be more effective than oral treatment only (RR for parasitological cure 3.00, 95% CI 1.10 to 8.16; 4 trials, n=426). Partner treatment was effective in decreasing long-term re-infection rates (RR, two months after treatment, 0.21, 95% CI 0.06 to 0.71; 1 trial, n=118).
The USA Centers for Disease Control and Prevention 2 evaluated the treatment of trichomoniasis. It can be cured with single-dose therapy of an appropriate nitroimidazole antibiotic, but women who are also infected with HIV should receive therapy for 7 days.
Primary/Secondary Keywords