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Recording available 2/16-5/2
Recording available 2/16-5/2
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Poster Session 4

Category: Infectious Diseases

Poster Session 4

(1180) Single versus Seven-Day Treatment Dosing for Metronidazole in Pregnancies Complicated by Trichomonas Vaginalis Infections

Thursday, February 12, 2026
3:30 PM - 5:00 PM  

    Submitting Author(s)

  • Daniel J. Martingano, DO, MBA, PhD

    Clerkship Director, IRB Chair, Associate Program Director / Division Chair
    St. John's Episcopal Hospital-South Shore / Lake Erie College of Osteopathic Medicine
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

    • Presenting Author(s)

  • Melody Boafo, MD

    OB/GYN Resident
    St. John's Episcopal Hospital-South Shore
    hackettstown, New Jersey, United States

    • Coauthor(s)

  • AR

    Andrea Rivera, MD

    OB/GYN Resident
    Wyckoff Heights Medical Center
    Wyckoff Heights Medical Center / Brooklyn, New York, United States

  • AN

    Ashley Nguyen, MD

    OB/GYN Resident
    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

  • Marwah Al-Dulaimi, MD (she/her/hers)

    OB/GYN Resident
    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore, New York, United States

  • GL

    Ginny Zizhen Liu, MS

    William Carey University
    William Carey University, Mississippi, United States

  • JD

    Jaina Diaz-Kelly, MS

    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

  • KH

    Kristen Henry, MS

    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

  • KM

    Kelly Mondey, MS

    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

  • BR

    Brenna M. Regan, MS

    William Carey University College of Osteopathic Medicine
    William Carey University / Hattiesburg, Mississippi, United States

  • GO

    Gloria Otoo, MSN, PhD

    RNC-OB
    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

  • KC

    Kristen Cohen, CNM, DNP

    CNM WHNP-OB
    RWJBarnabas Health Trinitas Regional Medical Center
    RWJBarnabas Trinitas Regional Medical Center / Elizabeth, New Jersey, United States

  • ES

    Eddie Santana, DO

    MFM Fellow
    Good Samaritan University Hospital / NYIT
    Good Samaritan University Hospital / West Islip, New York, United States

  • AO

    Angelo Oduro, DO

    OBGYN Residency Program Director
    St. John's Episcopal Hospital-South Shore / Lake Erie College of Osteopathic Medicine
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

  • JM

    Jacqueline Marecheau, MD

    Chairperson, Department of OB/GYN
    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

Objective:

Trichomonas vaginalis (TV) commonly affects pregnant women with an increasing incidence and has been linked to several adverse birth outcomes. This study sought compare the effectiveness of different dosing regimens for metronidazole (MT) in the treatment of TV in 2nd and 3rd trimester pregnancies.


Study Design:

We conducted a multi-center, prospective observational study from 7/2022 to 7/2025 and included all pregnant women diagnosed with TV from 20 0/7 to 40 0/7 weeks-gestation receiving monotherapy antibiotic treatment with oral MT. Drug regimens considered include a single dose of 2000mg (SD) or a 7-day course of 500mg twice daily (WD). Choice of regimen was determined by physician preference. Primary outcomes included need for additional medication doses, positive test-of-cure (performed at 4 weeks post-treatment), ascending infection (Fitz-Hugh-Curtis Syndrome), sepsis, early preterm delivery defined at < 34 0/7 weeks-gestation, late preterm delivery defined at 34 1/7 to 36 6/7 weeks-gestation, preterm prelabor rupture of membranes (PPROM) defined at < 37 0/7 weeks-gestation, and fetal growth restriction defined as EFW < 10th percentile, as discrete events. Patients were excluded if they received additional antibiotics within a week before TV diagnosis, received treatment IV or IM, had preexisting immunologic conditions, or had concurrent sexually transmitted infections.

Results:

The study included 1127 patients, with 473 receiving SD and 654 receiving WD. Baseline demographic factors were not significantly different. Patients receiving SD had lower rates of positive test-of-cure (21.9% v. 36.2% p=0.003), and need for additional medication (19.4% v. 35.1% p=0.004), with a 33% (RR=0.67, 95% CI 0.41-0.90, p=0.022) and 29% (RR=0.71, 95% CI 0.43-0.86, p=0.030 decreased risk in confounder adjusted models, respectively. Patients receiving WD had increased rates of PPROM (6.7% v. 4.9% p=0.010), and a 19% (RR=1.19, 95% CI 1.03-1.44, p=0.030) increased risk in adjusted models.

Conclusion:

Single-dose metronidazole is a reasonable and possible superior dosing choice for pregnancies complicated by TV.