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Trichomonas vaginalis affects 5.3% of women globally.1 It is associated with multiple adverse outcomes including pelvic inflammatory disease, infertility, HIV and sexually transmitted infection (STI) acquisition/transmission, cervical cancer and adverse birth outcomes.1 5-nitroimidazoles (metronidazole [MTZ], tinidazole [TDZ], secnidazole [SEC]) are the only drug class approved for treatment.2 MTZ became available in 1960, with reports of drug resistance emerging 2 years later.1 TDZ and SEC drug-resistant cases have also been published.1 Diagnosing and treating resistant T. vaginalis is challenging, particularly during pregnancy.