Effective therapies exist for the treatment of both vaginal trichomoniasis and bacterial vaginosis (BV). Recurrent trichomonas infection is uncommon, and significant metronidazole resistance remains rare. The management of metronidazole-resistant trichomoniasis is dependent on susceptibility studies, which can be used to guide higher doses of metronidazole therapy. Recurrent BV is common. A mechanism for reestablishing the normal vaginal flora with H2O2-producing lactobacilli remains elusive. The management of this recurrent infection is based upon a longer duration of therapy with currently available antibiotic regimens and documentation of a clinical response using composite clinical criteria and Gram's stain of the vaginal secretions.