Vaginitis medical therapy

Vaginitis Main Page
Patient Information
Overview
Classification Bacterial Vaginosis Candida vulvovaginitis Trichomonas infection Atrophic Vaginitis
Differential Diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The cause of the infection determines the appropriate treatment. It may include oral or topical antibiotics and/or antifungal creams, antibacterial creams, or similar medications. A cream containing cortisone may also be used to relieve some of the irritation. If an allergic reaction is involved, an antihistamine may also be prescribed. For women who have irritation and inflammation caused by low levels of estrogen (postmenopausal), a topical estrogen cream might be prescribed.

Bacterial Vaginosis

Bacterial Vaginosis Treatment Preferred Regimen ▸ Metronidazole 0.5 gm po bid x 7 days OR ▸ Metronidazolevaginal gel (1 applicator intravaginally) once daily x 5 days or 1 applicator contains 5 gm of gel with 37.5 mg Metronidazole OR ▸ Tinidazole 2 gm po once daily x 2 days or 1 gm po once daily x 5 days OR ▸ Clindamycin 2% vaginal cream 5 gm intravaginally at bedtime x 7 days Alternative Regimen ▸ Clindamycin 300 mg bid po x 7 days OR ▸ Clindamycin ovules 100 mg intravaginally at bedtime x 3 days Recurrent refractory BV ▸ Metronidazole 0.5 gm po bid x 7 days then Boric acid gelatin cap 600 mg, intravaginal hs x 21 days then Metronidazole vaginal gel, 1 applicator, 2 x/week for 16 weeks

Trichomoniasis

Trichomoniasis Treatment Preferred Regimen ▸ Metronidazole 2 g po single dose OR ▸ Tinidazole 2 g po single dose Alternative Regimen ▸ Metronidazole 500 mg bid for 7 days

Candida

Candida Vaginitis Treatment Preferred Regimen Oral ▸ Fluconazole 150 mg po x 1 dose OR ▸ Itraconazole 200 mg po bid x 1 day Intravaginal ▸ Any of the following topical antifungals x 7-14 days clotrimazole butoconazole miconazole tioconazole as creams or vaginal suppositories Alternative Regimen ▸ Fluconazole 150 mg po q week x 6 months OR ▸ Itraconazole 100 mg po q24h x 6 months OR ▸ Clotrimazole vaginal suppositories 500 mg q week x 6 months