Treatment of Recurrent Bacterial Vaginosis
Initial Treatment and Suppressive Therapy
- The Centers for Disease Control and Prevention recommends treating recurrent bacterial vaginosis with metronidazole 500 mg orally twice daily for 10-14 days, followed by suppressive therapy with metronidazole gel 0.75% twice weekly for 3-6 months to reduce recurrence rates from approximately 60% to 25% 1
- The American College of Obstetricians and Gynecologists advises against treating sexual partners routinely, as multiple trials demonstrate that partner treatment does not influence recurrence rates or treatment response 2, 3, 1
Special Populations
- The Centers for Disease Control and Prevention recommends treating all symptomatic pregnant women with metronidazole 250 mg orally three times daily for 7 days after the first trimester 3, 4, 5
- For pregnant women at high risk, the Centers for Disease Control and Prevention suggests considering follow-up evaluation at 1 month after treatment completion 3