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

The recommended treatment for trichomonas vulvovaginitis is oral metronidazole (Flagyl). This is because metronidazole is specifically effective against Trichomonas vaginalis, the protozoan responsible for this infection. Administering it orally achieves adequate systemic levels to eradicate the organism and resolve symptoms effectively.

In this treatment, the oral route is preferred over topical administration as it provides better systemic absorption and effectiveness in clearing the infection. Treatment with metronidazole typically results in rapid improvement in symptoms and eradication of the pathogen, aligning with clinical guidelines for managing trichomoniasis.

The other options are not appropriate for trichomonas vulvovaginitis. For instance, topical metronidazole, while also an effective treatment, is less favored compared to the oral route in adult women with this condition. Oral fluconazole is an antifungal and is used for Candida infections, not for trichomoniasis. Topical estradiol cream is used for atrophic vaginitis or other estrogen-deficiency related conditions, which is unrelated to the treatment of trichomonas. Hence, oral metronidazole remains the best choice for treating this infection.