Guidelines for the Management of Sexually Transmitted Infections. February 2004
(2004; 88 pages)
Table of Contents
View the documentPREFACE
Open this folder and view contents1. INTRODUCTION
Open this folder and view contents2. TREATMENT OF STI-ASSOCIATED SYNDROMES
Close this folder3. TREATMENT OF SPECIFIC INFECTIONS
Open this folder and view contents3.1. Gonococcal infections
Open this folder and view contents3.2. Chlamydia trachomatis infections (other than lymphogranuloma venereum)
View the document3.3. Lymphogranuloma venereum
Open this folder and view contents3.4. Syphilis
View the document3.5. Chancroid
View the document3.6. Granuloma inguinale (Donovanosis)
Open this folder and view contents3.7. Genital herpes infections
Open this folder and view contents3.8. Venereal warts
View the document3.9. Trichomonas vaginalis infections
Close this folder3.10. Bacterial vaginosis
View the documentBacterial vaginosis in pregnancy
Open this folder and view contents3.11. Candidiasis
View the document3.12. Scabies
View the document3.13. Phthiriasis (pediculosis pubis)
Open this folder and view contents4. KEY CONSIDERATIONS UNDERLYING TREATMENTS
Open this folder and view contents5. PRACTICAL CONSIDERATIONS IN STI CASE MANAGEMENT
Open this folder and view contents6. CHILDREN6, ADOLESCENTS AND SEXUALLY TRANSMITTED INFECTIONS
View the documentANNEX. LIST OF PARTICIPANTS
 

3.10. Bacterial vaginosis

Bacterial vaginosis is a clinical syndrome resulting from replacement of the normal hydrogen peroxide (H2O2)-producing Lactobacillus sp. in the vagina with high concentrations of anaerobic bacteria, such as G. vaginalis and Mycoplasma hominis. The cause of the microbial alteration is not fully understood.

Whereas trichomoniasis is a sexually transmitted infection, bacterial vaginosis is an endogenous reproductive tract infection. Treatment of sexual partners has not been demonstrated to be of benefit. It is recommended that predisposing factors such as the use of antiseptic/antibiotic vaginal preparations or vaginal douching be reduced or eliminated.

Additional studies are needed to confirm the relationship between an altered vaginal microflora and the acquisition of HIV

The current recommendation is to only treat symptomatic women.

Recommended regimen

• metronidazole, 400 or 500mg orally, twice daily for 7 days

Note

Patients taking metronidazole should be cautioned not to consume alcohol while they are taking the drug and up to 24 hours after taking the last dose.

Alternative regimens

• metronidazole, 2g orally, as a single dose

OR

• clindamycin vaginal cream 2%, 5g at bedtime intravaginally for 7 days

OR

• metronidazole gel 0.75%, 5g twice daily intravaginally for 5 days

OR

• clindamycin, 300mg orally twice daily for 7 days.

Follow-up

Patients should be advised to return if symptoms persist as re-treatment may be needed.

BACTERIAL VAGINOSIS AND SURGICAL PROCEDURES

Women with bacterial vaginosis, scheduled to undergo reproductive tract surgery or a therapeutic abortion, should receive treatment with metronidazole.

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