BASHH. UK National Guideline on the Management of Trichomonas vaginalis. British Association for Sexual Health and HIV. 2007. http://www.bashh.org/documents/87/87.pdf Accessed 23.09.14. RATIONALE: Treatment of partners: the recommendation to also treat partners for trichomoniasis, irrespective of the results of investigations is based on two prospective RCTs.

UKTIS. Use of metronidazole in pregnancy. The UK Teratology Information Service. 2008. (Tel: 0844 892 0909, http://www.uktis.org/docs/Metronidazole.pdf ) Accessed 23.09.14. RATIONALE: Metronidazole was shown to be mutagenic and carcinogenic in some animal studies. However available data, which is almost exclusively based on oral exposure, does not indicate an increased risk of adverse fetal effects associated with metronidazole use in human pregnancy. Where possible, the results of culture and sensitivity tests should be available before making a treatment choice. However if treatment is required before test results become available, then penicillins or cephalosporins may be used if considered clinically appropriate. The manufacturer advises avoidance of the 2g stat regimen during pregnancy.

Du Bouchet I, Spence MR, Rein MF, Danzig MR, McCormack WM. Multicentre comparison of clotrimazole vaginal tablets, oral metronidazole, and vaginal suppositories containing sulphanilamide, aminacrine hydrochloride, and allantoin in the treatment of symptomatic trichomoniasis. Sex Transm Dis 1997;24:156-160. RATIONALE: In this randomized, open-label trial (n = 168) clotrimazole vaginal tablets were not found to effectively eradicate trichomoniasis. However, a reduction in symptoms was reported. The numbers of patients who had positive cultures after treatment were 40/45 (88.9%) in the clotrimazole group, 35/43 (81.4%) in the AVC suppository group, and 9/45 (20%) in the metronidazole group (P < 0.001).

Forna F, Gulmezoglu MU. Interventions for treating trichomoniasis in women. Cochrane Database of Systematic Reviews. 2003. Issue 2. http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000218/frame.html Accessed 23.09.14. RATIONALE: Pooled data from two RCTs (n = 294) found an 88% cure rate in women treated with metronidazole 2 g stat compared with a 92% cure rate in women treated with metronidazole for 5 or 7days. Relative risk of no parasitological cure 1.12, 95% CI 0.58 to 2.16.

The POCAST project is funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London and by the Imperial College Healthcare Charity (Grant Ref No:7006/P36U).