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Bacterial vaginosis - Management
How should I manage a woman with recurrent symptoms?
- Recurrence of symptoms is common.
- Reconsider the diagnosis of bacterial vaginosis (BV).
- Perform a speculum examination and take swabs if this has not been previously done.
- Further examination and investigations may not be necessary if a previous episode of recognizably similar symptoms was previously diagnosed to be BV and:
- Characteristic symptoms and signs of BV were present.
- Symptoms, signs, and microbiological evidence from swabs of other conditions causing vaginal discharge were absent.
- Symptoms and signs cleared after antibiotic treatment.
- Treat the current episode with a 7-day course of oral metronidazole.
- Advise the woman that it may be beneficial to avoid vaginal douching, use of shower gel, and the use of antiseptics, bubble baths, or shampoos in the bath.
- If the diagnosis is confirmed and symptoms recur frequently (at least four times a year) despite adequate management in primary care, and symptoms are adversely affecting the woman, consider discussing management with a gynaecologist or genito-urinary medicine specialist.
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