Don't ignore trichomoniasis

Treatment
For more than 30 years one drug, metronidazole (Flagyl or generic), has been the standard to treat trichomoniasis with a success rate of 95 per cent. In most cases, infection is cured in women with a single oral dose of two grams. Pregnant women may be treated at any time. There is no reason for a follow-up visit if you do not have symptoms after the treatment or if you had no symptoms before treatment. For those who fail treatment, longer courses of metronidazole are recommended, usually for three to five days.

It is very important not to drink alcohol when taking metronidazole and for 48 hours after the drug treatment is stopped. This is because the two interact, causing the patient to be extremely unwell.

Tinidazole is a 'one-off' treatment. It is the same class of drug as metronidazole, but it is not recommended during pregnancy or when breastfeeding.

< It is important that all sexual partners are treated, and that you avoid sexual contact until given the all-clear from your prescribing doctor.

Prevention
Prevention is similar to that for other STIs, and includes:

• Use a latex condom each and every time you have sex
• Limit your number of sexual partners
• Get tested if you think you have an STI and have your partner tested, too

You can reduce your risk of acquiring vaginitis if you:

• Avoid douching
• Take antibiotics only as necessary

Prognosis
Metronidazole will cure 95 per cent of cases. In the remaining five per cent, failure to respond to metronidazole can be attributed to failure to comply with treatment or re-infection by an untreated partner. A repeat course of antibiotics usually cures the patient if treatment was not initially successful. In a minority of cases, co-existent streptococcal infection reduces efficacy of metronidazole and needs to be treated first before further treatment with the drug.