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Bacterial vaginosis - Management
Basis for recommendation
Antibiotic choice for eradication of bacterial vaginosis
- Evidence from a Cochrane systematic review (10 randomized controlled trials) indicated that both oral and intravaginal antibiotics are effective at eradicating bacterial vaginosis in pregnant women. Although there was no direct comparison, oral antibiotics appeared to have similar efficacy to intravaginal antibiotics, and clindamycin (oral or intravaginal) appeared to have similar efficacy to other antibiotic treatments.
- High-dose regimens of metronidazole (2 g single dose) are not recommended in pregnancy [ABPI Medicines Compendium, 2008; BNF 56, 2008].
- Metronidazole is preferred over tinidazole in women who are pregnant because there is more experience with metronidazole.
Test of cure
- The recommendation to test all pregnant women 1 month after completion of treatment is based on expert opinion and is consistent with UK guidelines [RCGP and BASHH, 2006].
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