NEW APPROACHES FOR THE TREATMENT OF BACTERIAL VAGINOSIS

OBJECTIVE: Review alternative approaches to oral metronidazole for the treatment of bacterial vaginosis. STUDY DESIGN: Assessment of clinical trials on the treatment of bacterial vaginosis with regimens other than 5 to 7 days of metronidazole. RESULTS: Single-dose metronidazole, 2 gm orally is as effective as 5- to 7-day courses of oral metronidazole, with cure rates in the 80% to 90% range. Oral clindamycin results in more than a 90% clinical cure rate. Intravaginal clindamycin cream 2% and intravaginal metronidazole gel 0.75% are associated with clinical cure rates similar to those for oral metronidazole. CONCLUSIONS: Single-dose metronidazole, oral clindamycin, intravaginal clindamycin cream, and intravaginal metronidazole gel are effective and safe alternatives to a 5- to 7-day course of oral metronidazole for the treatment of bacterial vaginosis.