Tinidazole for the treatment of vaginal infections

Expert Opin Investig Drugs. 2007 May;16(5):743-51. doi: 10.1517/13543784.16.5.743.


Tinidazole has been used for vaginal infection worldwide but not in the US for > 40 years. Recently, tinidazole has been re-introduced and approved by the FDA for trichomoniasis and restudied as an alternative to metronidazole for bacterial vaginosis. In vitro antimicrobial activity and pharmacokinetics studies indicate that tinidazole has minor but possibly relevant antimicrobial as well as pharmacokinetic advantages when compared directly with metronidazole. Clinical comparison has been infrequent although the limited head-to-head studies indicate minimal therapeutic advantage with tinidazole. Perhaps the more relevant differences relate to the enhanced tolerance and reduced toxicity of tinidazole. Ongoing, as yet incomplete, studies directly comparing the clinical efficacy of metronidazole and tinidazole for bacterial vaginosis should clarify the status of tinidazole; however, cure rates are unlikely to be significantly different. Although uncommon, high-level trichomonal metronidazole resistance can be reliably cured by using tinidazole, which is an invaluable advantage.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antitrichomonal Agents / administration & dosage
  • Antitrichomonal Agents / adverse effects
  • Antitrichomonal Agents / pharmacokinetics
  • Antitrichomonal Agents / therapeutic use*
  • Drug Administration Schedule
  • Drug Interactions
  • Drug Resistance
  • Female
  • Humans
  • Metronidazole / therapeutic use
  • Microbial Sensitivity Tests
  • Parasitic Sensitivity Tests
  • Tinidazole / administration & dosage
  • Tinidazole / adverse effects
  • Tinidazole / pharmacokinetics
  • Tinidazole / therapeutic use*
  • Treatment Outcome
  • Trichomonas Vaginitis / drug therapy*
  • Vaginosis, Bacterial / drug therapy*
  • Vaginosis, Bacterial / microbiology


  • Anti-Bacterial Agents
  • Antitrichomonal Agents
  • Tinidazole
  • Metronidazole