Successful Treatment of Highly Resistant Trichomoniasis with Tinidazole and Paromomycin Regimen after Boric Acid failure

Metronidazole and tinidazole resistance with Trichomonas vaginalis is increasing. Paromomycin cream with high dose tinidazole is effective, though vulvovaginal ulceration has limited its use. We describe two patients who failed high dose tinidazole and boric acid who were successfully treated with tinidazole and paromomycin and summarize relevant literature. Summary: Paromomycin and tinidazole used in combination may be more effective than combination therapy with boric acid in eradicating treatment resistant trichomonas.