Metronidazole

Switch to mobile view »

Oral metronidazole was the only efficacious antibiotic available for the treatment of trichomoniasis in the United States before the FDA approved tinidazole.1 In clinical trials, it has demonstrated a cure rate of 90-95%.2

Clinically metronidazole-resistant strains of T. vaginalis are increasing, and cases have been reported across the United States.3,4 According to the CDC, low-level metronidazole resistance has been identified in 2-5% of cases.2

Generally, treatment of resistant cases consists of higher and more prolonged doses of metronidazole.2 In cases of trichomoniasis highly resistant to metronidazole, tinidazole is often effective.5-8

Patient tolerance becomes a limiting factor with high dose metronidazole therapy. Tinidazole is reportedly less toxic and better tolerated than metronidazole.6,7

Metronidazole intravaginal gel is not considered an efficacious treatment for trichomoniasis.1,2 According to the CDC, "Topically applied antimicrobials (e.g., metronidazole gel) are unlikely to achieve therapeutic levels in the urethra or perivaginal glands; therefore use of the gel is not recommended."2

See Cure Comparison for more information.

  1. Schwebke JR, Burgess D. Trichomoniasis. Clin Microbiol Rev. 2004 Oct;17(4):794-803.
  2. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines 2006. MMWR 2006;55(RR11):1-94.
  3. Sobel JD. Vaginitis. N Engl J Med. 1997 Dec 25;337(26):1896-903.
  4. Schmid G, Narcisi E, Mosure D, Secor WE, Higgins J, Moreno H. Prevalence of metronidazole-resistant Trichomonas vaginalis in a gynecology clinic. J Reprod Med. 2001 Jun;46(6):545-9.
  5. Mammen-Tobin A, Wilson JD. Management of metronidazole-resistant Trichomonas vaginalis--a new approach. Int J STD AIDS. 2005 Jul;16(7):488-90.
  6. Sobel JD, Nyirjesy P, Brown W. Tinidazole therapy for metronidazole-resistant vaginal trichomoniasis. Clin Infect Dis. 2001 Oct 15;33(8):1341-6. Epub 2001 Sep 17.
  7. Nailor MD, Sobel JD. Tinidazole for the treatment of vaginal infections. Expert Opin Investig Drugs. 2007 May;16(5):743-51.
  8. Nanda N, Michel RG, Kurdgelashvili G, Wendel KA. Trichomoniasis and its treatment. Expert Rev Anti Infect Ther. 2006 Feb;4(1):125-35.
Sponsored by Tindamax (tinidazole)