Bacterial vaginosis medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
== | ==Antimicrobial Regimen== | ||
Bacterial | :* 1.'''Bacterial Vaginosis Treatment'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref> | ||
:::* Preferred regimen (1): [[Metronidazole]] 500 mg PO bid for 7 days | |||
:::* Preferred regimen (2): [[Metronidazole]] gel 0.75%, one full applicator (5 g) intravaginally, qd for 5 days | |||
:::* Preferred regimen (3): [[Clindamycin]] cream 2%, one full applicator (5 g) intravaginally at bedtime for 7 days | |||
:::* Alternative regimen (1): [[Tinidazole]] 2 g PO qd for 2 days | |||
:::* Alternative regimen (2): [[Tinidazole]] 1 g PO qd for 5 days | |||
:::* Alternative regimen (3): [[Clindamycin]] 300 mg PO bid for 7 days | |||
:::* Alternative regimen (4): [[Clindamycin]] ovules 100 mg intravaginally once at bedtime for 3 days | |||
:::* Note: [[Clindamycin]] ovules use an oleaginous base that might weaken latex or rubber products (e.g., condoms and vaginal contraceptive diaphragms). Use of such products within 72 hours following treatment with clindamycin ovules is not recommended. | |||
::* 2. '''Management of Sex Partners''' | |||
:::* Routine treatment of sex partners is not recommended. | |||
::* 3. '''Special Considerations''' | |||
:::* 3.1 '''Allergy, Intolerance, or Adverse Reactions''' | |||
:::* Intravaginal [[Clindamycin]] cream is preferred in case of allergy or intolerance to [[Metronidazole]] or [[Tinidazole]]. Intravaginal [[Metronidazole]] gel can be considered for women who are not allergic to [[Metronidazole]] but do not tolerate oral metronidazole. It is advised to avoid consuming alcohol during treatment with nitroimidazoles. To reduce the possibility of a disulfiram-like reaction, abstinence from alcohol use should continue for 24 hours after completion of metronidazole or 72 hours after completion of tinidazole. | |||
::* 3.2 '''Pregnancy''' | |||
:::* Preferred regimen (1): [[Metronidazole]] 500 mg PO bid for 7 days | |||
:::* Preferred regimen (2): [[Metronidazole]] gel 0.75%, one full applicator (5 g) intravaginally, qd for 5 days | |||
:::* Note: [[Tinidazole]] should be avoided during pregnancy | |||
::*3.3 '''HIV Infection''' | |||
:::* Women with HIV who have BV should receive the same treatment regimen as those who do not have HIV infection. | |||
0.75%, one full applicator (5 g) intravaginally, | |||
''' | |||
==References== | ==References== | ||
Revision as of 17:47, 11 August 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Treatment with appropriate antibiotics is recommended in all symptomatic women and high risk asymptomatic pregnant women.
Medical Therapy
Antimicrobial Regimen
- 1.Bacterial Vaginosis Treatment[1]
- Preferred regimen (1): Metronidazole 500 mg PO bid for 7 days
- Preferred regimen (2): Metronidazole gel 0.75%, one full applicator (5 g) intravaginally, qd for 5 days
- Preferred regimen (3): Clindamycin cream 2%, one full applicator (5 g) intravaginally at bedtime for 7 days
- Alternative regimen (1): Tinidazole 2 g PO qd for 2 days
- Alternative regimen (2): Tinidazole 1 g PO qd for 5 days
- Alternative regimen (3): Clindamycin 300 mg PO bid for 7 days
- Alternative regimen (4): Clindamycin ovules 100 mg intravaginally once at bedtime for 3 days
- Note: Clindamycin ovules use an oleaginous base that might weaken latex or rubber products (e.g., condoms and vaginal contraceptive diaphragms). Use of such products within 72 hours following treatment with clindamycin ovules is not recommended.
- 2. Management of Sex Partners
- Routine treatment of sex partners is not recommended.
- 3. Special Considerations
- 3.1 Allergy, Intolerance, or Adverse Reactions
- Intravaginal Clindamycin cream is preferred in case of allergy or intolerance to Metronidazole or Tinidazole. Intravaginal Metronidazole gel can be considered for women who are not allergic to Metronidazole but do not tolerate oral metronidazole. It is advised to avoid consuming alcohol during treatment with nitroimidazoles. To reduce the possibility of a disulfiram-like reaction, abstinence from alcohol use should continue for 24 hours after completion of metronidazole or 72 hours after completion of tinidazole.
- 3.2 Pregnancy
- Preferred regimen (1): Metronidazole 500 mg PO bid for 7 days
- Preferred regimen (2): Metronidazole gel 0.75%, one full applicator (5 g) intravaginally, qd for 5 days
- Note: Tinidazole should be avoided during pregnancy
- 3.3 HIV Infection
- Women with HIV who have BV should receive the same treatment regimen as those who do not have HIV infection.