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Bacterial vaginosis - Management
How should I treat a pregnant woman with bacterial vaginosis?
- Oral metronidazole is the treatment of choice.
- A dose of 400 mg twice a day for 7 days is recommended.
- High-dose regimens (single oral dose of 2 g) are not recommended during pregnancy.
- Intravaginal metronidazole gel or intravaginal clindamycin cream are alternative choices for achieving cure if the woman prefers a topical treatment or is unable to tolerate oral metronidazole:
- Intravaginal metronidazole gel 0.75% once a day for 5 days, or
- Intravaginal clindamycin cream 2% once a day for 7 days.
- Oral clindamycin may also be considered, but is less preferred.
- Oral clindamycin (300 mg twice a day for 7 days) is not widely recommended in primary care because of an increased risk of pseudomembranous colitis.
- Testing should be repeated after 1 month to ensure that cure was achieved.
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