Which metronidazole regimen is recommended for Trichomoniasis?

• A. Metronidazole 500 mg PO twice daily for 7 days
• B. Metronidazole 2 grams PO single dose
• C. Tinidazole 2 grams PO single dose
• D. Metronidazole 250 mg PO three times daily for 7 days

Answer: (B)

For Trichomoniasis, the goal is to cure the infection with a regimen that patients are most likely to complete. A single 2-gram dose of metronidazole taken by mouth achieves high cure rates while maximizing adherence, making it the preferred option for uncomplicated infection. Short, one-time treatment reduces the chance of missed doses and the need for multiple daily pills over several days, which typically leads to better real-world effectiveness. In contrast, regimens that spread out the dose over seven days require many more doses and can be harder to follow, lowering the chance of full cure. While a single 2-gram dose of tinidazole is also effective, the question focuses on a metronidazole regimen, and among metronidazole options, the single-dose approach is the simplest and most reliable. Remember to treat sexual partners as well to prevent reinfection.