Treatment of Bacterial Vaginosis

Evidence-Based Recommendations

The Centers for Disease Control and Prevention (CDC) guidelines state that treatment of sex partners has not been shown to influence the woman's response to therapy or affect relapse/recurrence rates 1, 2, 3
The principal goal of therapy for BV is to relieve vaginal symptoms and signs of infection in the affected woman, not to prevent transmission 3, 4
The CDC recommends that male sex partners of women with BV are typically asymptomatic, and treating them has traditionally not been considered necessary 3

First-line treatment options for women with BV include oral metronidazole 500 mg twice daily for 7 days (95% cure rate) 5
Alternative options include oral metronidazole 2g as a single dose (84% cure rate) 5

Patients using metronidazole should avoid alcohol during treatment and for 24 hours afterward due to potential disulfiram-like reaction 1, 5
Clindamycin cream is oil-based and may weaken latex condoms and diaphragms 5, 6