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[2] [1] The cure rates against BV with TOL-463 were said to be comparable to those with recently approved antibiotic treatments like single-dose oral secnidazole (58%) and single-dose metronidazole vaginal gel (41%). [1] As of July 2022, TOL-463 is in phase 2 clinical trials for the treatment of BV and VVC. [3]
[19] [58] Other antibiotics related to metronidazole, including tinidazole and the newer secnidazole, are also approved and used to treat BV. [ 9 ] [ 59 ] [ 60 ] When clindamycin is given to pregnant women symptomatic with BV before 22 weeks of gestation the risk of pre-term birth before 37 weeks of gestation is lower. [ 61 ]
Metronidazole, sold under the brand name Flagyl among others, is an antibiotic and antiprotozoal medication. [10] It is used either alone or with other antibiotics to treat pelvic inflammatory disease, endocarditis, and bacterial vaginosis. [10] It is effective for dracunculiasis, giardiasis, trichomoniasis, and amebiasis. [10]
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Infection is treated and cured with metronidazole [16] or tinidazole. The CDC recommends a one time dose of 2 grams of either metronidazole or tinidazole as the first-line treatment; the alternative treatment recommended is 500 milligrams of metronidazole, twice daily, for seven days if there is failure of the single-dose regimen. [17]
Single oral dose of nitroimidazole is sufficient to kill the parasites. [34] For 95–97% of cases, infection is resolved after one dose of metronidazole. [26] [35] Studies suggest that 4–5% of trichomonas cases are resistant to metronidazole, which may account for some "repeat" cases.