Editing Trichomoniasis (section)

==Treatment==
Treatment for both pregnant and non-pregnant women is usually with [[metronidazole]],<ref>[http://www.ashastd.org/learn/learn_vag_trich_tri.cfm#3 Vaginitis/Trichomoniasis :Treatment for trichomoniasis] {{webarchive|url=https://web.archive.org/web/20080401092100/http://www.ashastd.org/learn/learn_vag_trich_tri.cfm |date=2008-04-01 }}, [[American Social Health Association]]. Retrieved March 12, 2008.</ref> by mouth once.<ref name=":0">{{cite journal | vauthors = Workowski KA, Bolan GA | title = Sexually transmitted diseases treatment guidelines, 2015 | journal = MMWR. Recommendations and Reports | volume = 64 | issue = RR-03 | pages = 1–137 | date = June 2015 | pmid = 26042815 | pmc = 5885289 }}</ref> Caution should be used in pregnancy, especially in the first trimester.<ref name="pmid15489348">{{cite journal | vauthors = Cudmore SL, Delgaty KL, Hayward-McClelland SF, Petrin DP, Garber GE | title = Treatment of infections caused by metronidazole-resistant Trichomonas vaginalis | journal = Clinical Microbiology Reviews | volume = 17 | issue = 4 | pages = 783–93, table of contents | date = October 2004 | pmid = 15489348 | pmc = 523556 | doi = 10.1128/CMR.17.4.783-793.2004 }}</ref> Sexual partners, even if they have no symptoms, should also be treated.<ref name="gynekologie">{{cite book | last1= Rob | first1= Lukáš | last2= Martan | first2= Alois | last3= Citterbart | first3= Karel| title = Gynekologie | publisher= Galen | location= Prague | year= 2008 | edition= 2nd | isbn = 978-80-7262-501-7 | page= 136| language=cs|display-authors=etal}}</ref> Single oral dose of [[nitroimidazole]] is sufficient to kill the parasites.<ref>{{cite journal | vauthors = Forna F, Gülmezoglu AM | title = Interventions for treating trichomoniasis in women | journal = The Cochrane Database of Systematic Reviews | issue = 2 | pages = CD000218 | date = 2003-04-22 | pmid = 12804391 | pmc = 6532670 | doi = 10.1002/14651858.CD000218 | editor-last = Cochrane Infectious Diseases Group }}</ref>

For 95–97% of cases, infection is resolved after one dose of metronidazole.<ref name="Workowski KA 2010"/><ref>{{cite journal | vauthors = Niccolai LM, Kopicko JJ, Kassie A, Petros H, Clark RA, Kissinger P | title = Incidence and predictors of reinfection with Trichomonas vaginalis in HIV-infected women | journal = Sexually Transmitted Diseases | volume = 27 | issue = 5 | pages = 284–8 | date = May 2000 | pmid = 10821602 | doi = 10.1097/00007435-200005000-00009 | s2cid = 37556873 | doi-access = free }}</ref> Studies suggest that 4–5% of trichomonas cases are resistant to metronidazole, which may account for some "repeat" cases.<ref name="pmid15489348"/><ref name=Secor>{{cite journal | vauthors = Secor WE, Meites E, Starr MC, Workowski KA | title = Neglected parasitic infections in the United States: trichomoniasis | journal = The American Journal of Tropical Medicine and Hygiene | volume = 90 | issue = 5 | pages = 800–804 | date = May 2014 | pmid = 24808247 | pmc = 4015567 | doi = 10.4269/ajtmh.13-0723 }}</ref> Without treatment, trichomoniasis can persist for months to years in women, and is thought to improve without treatment in men.<ref name=Secor /> Women living with [[HIV]] infection have better cure rates if treated for seven days rather than with one dose.<ref name=":0" /><ref>{{cite journal | vauthors = Kissinger P, Mena L, Levison J, Clark RA, Gatski M, Henderson H, Schmidt N, Rosenthal SL, Myers L, Martin DH | display-authors = 6 | title = A randomized treatment trial: single versus 7-day dose of metronidazole for the treatment of Trichomonas vaginalis among HIV-infected women | journal = Journal of Acquired Immune Deficiency Syndromes | volume = 55 | issue = 5 | pages = 565–71 | date = December 2010 | pmid = 21423852 | pmc = 3058179 | doi = 10.1097/qai.0b013e3181eda955 }}</ref>

Topical treatments are less effective than oral antibiotics due to [[Skene's gland]] and other genitourinary structures acting as reservoirs.<ref>{{cite journal | vauthors = Petrin D, Delgaty K, Bhatt R, Garber G | title = Clinical and microbiological aspects of Trichomonas vaginalis | journal = Clinical Microbiology Reviews | volume = 11 | issue = 2 | pages = 300–17 | date = April 1998 | pmid = 9564565 | pmc = 106834 | doi = 10.1128/CMR.11.2.300 }}</ref>

[[Vaginal administration|Vaginal]] [[boric acid (vaginal)|boric acid]] can be useful against resistant trichomoniasis.<ref name="LærkeholmMüllerDamstedPetersenSaunte2024">{{cite journal | last=Lærkeholm Müller | first=Matilde | last2=Damsted Petersen | first2=Christina | last3=Saunte | first3=Ditte Marie L. | title=Boric Acid for the Treatment of Vaginitis: New Possibilities Using an Old Anti‐Infective Agent: A Systematic Review | journal=Dermatologic Therapy | volume=2024 | issue=1 | date=2024 | issn=1396-0296 | doi=10.1155/2024/2807070 | doi-access=free | page=}}</ref><ref name="ThorleyRoss2018">{{cite journal | vauthors = Thorley N, Ross J | title = Intravaginal boric acid: is it an alternative therapeutic option for vaginal trichomoniasis? | journal = Sex Transm Infect | volume = 94 | issue = 8 | pages = 574–577 | date = December 2018 | pmid = 29223972 | doi = 10.1136/sextrans-2017-053343 | url = }}</ref><ref name="MittelstaedtKretzLevine2021">{{cite journal | vauthors = Mittelstaedt R, Kretz A, Levine M, Handa VL, Ghanem KG, Sobel JD, Powell A, Tuddenham S | title = Data on Safety of Intravaginal Boric Acid Use in Pregnant and Nonpregnant Women: A Narrative Review | journal = Sex Transm Dis | volume = 48 | issue = 12 | pages = e241–e247 | date = December 2021 | pmid = 34561373 | pmc = 10100571 | doi = 10.1097/OLQ.0000000000001562 | url = }}</ref>