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Standard therapy for vaginal trichomoniasis is oral metronidazole or tinidazole — but this treatment can cause gastrointestinal distress, and some strains of Trichomonas vaginalis are resistant. Investigators conducted a manufacturer-supported pilot study in which a vaginal suppository containing 750 mg metronidazole plus 200 mg miconazole was compared with a single 2-gm dose of oral metronidazole. A total of 40 women were randomized to the suppository once or twice daily for 7 days versus single-dose metronidazole.
Overall cure rates did not differ significantly for suppositories (range, 78%–80%) or oral metronidazole (range, 70%–90%). Molecular fingerprinting of trichomonas isolated from women with infections at follow-up suggested reinfec…