What is the recommended treatment for a patient diagnosed with trichomonas vulvovaginitis?

The recommended treatment for trichomonas vulvovaginitis is oral metronidazole (Flagyl). This medication is effective against the parasitic infection caused by Trichomonas vaginalis. It works by inhibiting nucleic acid synthesis in the organism, leading to its death.

Oral metronidazole is preferred over topical formulations for trichomoniasis because it provides more effective systemic coverage and ensures that the medication reaches the site of infection more thoroughly. Additionally, the oral route is more convenient for patients, requiring fewer applications and allowing for easier adherence to the treatment regimen.

While topical metronidazole is available, it is generally considered less effective for treating this particular condition compared to the oral form. Other options like oral fluconazole (used primarily for candidiasis) and topical estradiol cream (used for vulvovaginal atrophy or estrogen-deficient states) do not have any efficacy against Trichomonas vaginalis, making them inappropriate treatments for this diagnosis.