STD: Edited by Joseph A. DuncanUpdates in trichomonas treatment including persistent infection and 5-nitroimidazole hypersensitivityMuzny, Christina A.a; Van Gerwen, Olivia T.a; Kissinger, PatriciabAuthor Information aDivision of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama bDepartment of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA Correspondence to Patricia Kissinger, PhD, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street Suite 2004, New Orleans, LA 70112, USA. E-mail: email@example.com Current Opinion in Infectious Diseases: February 2020 - Volume 33 - Issue 1 - p 73-77 doi: 10.1097/QCO.0000000000000618 Buy Metrics Abstract Purpose of review The purpose of this review is to update information on treatment of Trichomonas vaginalis. T. vaginalis is estimated to be the most common treatable sexually transmitted infection. In the world and is associated with poor birth outcomes, cervical cancer, sperm motility and morphology issues, and HIV acquisition and transmission. Recent findings The efficacy of the recommended 2-g oral single-dose metronidazole (MTZ) for the treatment of T. vaginalis in women has recently been challenged. Two recent multicentered randomized trials and a meta-analysis have demonstrated that the 7-day dose of MTZ 500 mg twice daily was nearly two times more efficacious at clearing infection compared with the 2-g dose. Partner treatment is also essential, since up to 70% of male sexual partners can be infected and rescreening of treated women at 3 months is also recommended given the high repeat infection rates. Future studies should examine the importance of treating asymptomatic T. vaginalis, best treatment for men, the influence of the microbiome on treatment efficacy and different formulations of intravaginal treatments for hypersensitivity. Summary 7-day 500 mg twice daily MTZ should be used as the first line treatment for T. vaginalis-infected women. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.