Bacterial vaginosis: review of treatment options and potential clinical indications for therapy

We reviewed data on the treatment of bacterial vaginosis published from 1993 through 1996. For nonpregnant women, we recommend use of metronidazole (500 mg orally twice daily for 7 days), clindamycin vaginal cream (2%, once daily for 7 days), or metronidazole vaginal gel (0.75%, twice daily for 5 days) as the preferred treatment for bacterial vaginosis. For pregnant high-risk women (women with a prior preterm birth), the objective of the treatment is to prevent adverse outcomes of pregnancy, in addition to relief of symptoms. Thus, systemic therapy for possible subclinical upper tract infection as well as medication that has been studied in pregnant women are preferable. Therefore, we recommend metronidazole (250 mg orally three times a day for 7 days). For pregnant low-risk women (women without a prior preterm birth) with symptomatic disease, the main objective of the treatment is to relieve symptoms. We recommend metronidazole (250 mg orally three times a day for 7 days). Data do not support routine treatment of male sex partners.