Metronidazole - the most common antibiotic for BV. It is available:
•In tablet form, to be taken orally (swallowed) twice daily for seven days. Seen as the most effective treatment. This is also the preferred treatment if the woman is breastfeeding or pregnant.
•In tablet form, to be taken orally, just once. The BV is more likely to return with this treatment, compared to the seven-day tablet course.
•In gel form, that is applied to the vagina once daily, for five days.
•Clindamycin - this is an alternative BV treating antibiotic, often used if metronidazole did not work or the BV came back. It is available: ◦As a cream, which is applied to the vagina once daily for seven days.
◦In capsule form, which is taken orally (swallowed) twice daily for seven days. Rarely used today because of the risk of developing pseudomembranous colitis.
When taking clindamycin, barrier contraception methods, such as latex condoms, diaphragms and caps may be less effective. The woman should use addition contraception, such as condoms made from polyurethane.
Tinidazole - another antibiotic which is sometimes used to treat BV if metronidazole did not work, or the BV came back. Taken by mouth as a single dose. Alcohol must be avoided when taking this medication.
After completing the course of antibiotics - if symptoms go away the woman will not have to be tested for BV again. If the following occur, testing will need to be done again:◦Signs and symptoms of BV persist
◦Signs and symptoms of BV go away, and then come back
◦The patient being treated is pregnant
Additional treatment - approximately 10% to 15% of treatments are not effective. The doctor needs to check carefully that the patient followed the instructions on how to take the medication properly. If the medication did not work and the patient had done everything correctly, the doctor may prescribe a different antibiotic.
A GP (general practitioner, primary care physician) whose treatment was not effective may choose to refer the patient to a gynecologist - a doctor specialized in treating conditions of the female reproductive system. If a pregnant woman is having her pre-natal checks with a GP, she may be referred to an obstetrician (a doctor who specializes in pregnancies