Treatment for Bacterial Vaginosis

Treatment for bacterial vaginosis consists of antibiotics. A few antibiotic remedies are routinely used. Metronidazole (Flagyl) taken by either oral (pill) form or by vaginal metronidazole gel (Metrogel) is an effective cure. Also available is the vaginal clindamycin cream (Cleocin). The oral metronidazole can cause some minor but unpleasant side effects, but is believed to be the most effective treatment. The gels do not typically cause side effects, although yeast vaginitis can occur as a side effect of the medication.



Tinidazole (Tindamax) is an antibiotic that appears to have fewer side effects than metronidazole and is also effective in treating bacterial vaginosis.

Recurrence of bacterial vaginosis is possible even after successful treatment. More than half of those treated experience recurrent symptoms within 12 months. It is unclear why so many recurrent infections develop. With recurrent symptoms, a second course of antibiotics is generally prescribed.

What are complications of bacterial vaginosis?

Bacterial vaginosis can resolve completely without complications after treatment. No special follow-up is necessary if the symptoms disappear.

In pregnancy, bacterial vaginosis can cause premature labor, premature birth, infection of the amniotic fluid, and infection of the uterus after delivery. However, treatment of asymptomatic (not producing symptoms) bacterial vaginosis in pregnancy has not been shown to decrease the incidence of premature births in most studies. For these reasons, screening and treatment for bacterial vaginosis during pregnancy is controversial, and research is still being conducted to determine its utility and value. Currently the routine screening of all pregnant women is not recommended. However, screening and treatment of bacterial vaginosis is sometimes recommended for women with a history of a preterm birth.