• Metronidazole 2 g taken as a single oral dose with food

      or

• Tinidazole 2 g taken as a single oral dose with food

Avoid alcohol during and for 48 hours after imidazole containing treatment regimens

Persistence following stat treatment:

• Exclude non-compliance
• Ensure concomitant partner treatment
• Metronidazole 400 mg bd for 7 days or
• Metronidazole 2 g daily for 5 days or
• Tinidazole 2g daily for 5 days

If persistence remains, consult with a sexual health physician

Pregnancy:

• Symptomatic trichomoniasis:
  Manage as for nonpregnant woman. Metronidazole (category B) can be used in all trimesters Clotrimazole 1% vaginal cream can be used to relieve symptoms however there is a low cure rate

• Asymptomatic trichomoniasis:
  Currently controversial after a recent publication reported an increased risk of adverse pregnancy outcome in asymptomatic pregnant women with trichomonas treated with metronidazole - consult with senior sexual health physician