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

We reviewed data on the treatment of bacterial vaginosis published from 1989 through 1992 (articles published after the 1989 publication of the Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines). This review suggests that oral metronidazole (500 mg twice daily for 7 days) is the preferred treatment for bacterial vaginosis. Other effective (but alternative) treatment regimens include single-dose metronidazole (2 g orally), 2% clindamycin vaginal cream (once daily for 7 days), 0.75% metronidazole vaginal gel (twice daily for 5 days), and oral clindamycin (300 mg twice daily for 7 days). Data do not support the practice of routine treatment of male sex partners of infected females. Treatment of bacterial vaginosis during pregnancy should focus on the elimination of symptoms; data on adverse pregnancy outcomes for women with bacterial vaginosis remain insufficient to recommend treatment of asymptomatic patients. Before performing surgical abortion, treatment of bacterial vaginosis (symptomatic or asymptomatic) should be considered to prevent pelvic inflammatory disease.