Treatment of Non-Sexually Transmitted Gardnerella Infection

Introduction to Gardnerella Vaginalis

• The Centers for Disease Control and Prevention recommends that metronidazole 500 mg orally twice a day for 7 days remains the treatment of choice for Gardnerella vaginalis infections, regardless of transmission mode 1
• Gardnerella vaginalis is the primary agent of bacterial vaginosis (BV), a condition not considered primarily a sexually transmitted disease, although it may be associated with sexual activity 2, 1

Recommended Treatment Regimen

• The Centers for Disease Control and Prevention recommends metronidazole 500 mg orally twice a day for 7 days as the first-line treatment for BV 1
• An alternative regimen is metronidazole 2 g orally in a single dose, which has shown efficacy of 87% compared to 91% with the 7-day therapy 3

Special Considerations

• The Centers for Disease Control and Prevention advises that metronidazole is contraindicated in the first trimester of pregnancy, but may be used after the first trimester in a 2 g single dose 3
• Patients with HIV infection and BV should receive the same treatment as those without HIV 3, 1

Follow-up and Prevention

• Follow-up is necessary only if symptoms persist or recur, and a microbiological test of cure is not required in the absence of symptoms 1, 3
• Patients should abstain from sexual intercourse until completion of therapy and resolution of symptoms 3, 1