ANSWER: C
The preferred treatment for Trichomonas vaginitis is metronidazole, 2 g given in a single oral dose. Certain strains of Trichomonas vaginalis, however, have diminished sensitivity to metronidazole. Patients who fail initial treatment with metronidazole should be retreated with 500 mg orally twice a day for 7 days. If treatment fails again, the patient should be treated with 2 g daily for 3-5 days. Metronidazole gel and clindamycin cream are useful for treating bacterial vaginosis, but are not effective in the treatment of Trichomonas vaginitis. Sulfadiazine and pyrimethamine are used to treat toxoplasmosis.
Ref: Sexually transmitted diseases treatment guidelines-2002. MMWR 2002; 51(RR-6):43-45.
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