Bacterial Vaginosis Guidelines

Updated: Aug 16, 2021
  • Author: Philippe H Girerd, MD; Chief Editor: Michel E Rivlin, MD  more...
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Guidelines

Guidelines Summary

In 2021, the Centers for Disease Control and Prevention (CDC) updated its clinical practice guidelines on the treatment of sexually transmitted infections. [21] These are some of the highlights of the recommendations for the treatment of bacterial vaginosis.

The recommended treatment regimens for bacterial vaginosis are as follows:

  • Metronidazole at 500 mg PO BID for 7 days OR
  • Metronidazole gel 0.75% one full applicator (5 g) intravaginally once daily for 5 days OR
  • Clindamycin cream 2% one full applicator (5 g) intravaginally at bedtime for 7 days

Alternative treatment regimens for bacterial vaginosis are as follows:

  • Clindamycin at 300 mg PO BID for 7 days OR
  • Clindamycin ovules 100 mg intravaginally once at bedtime for 3 days (oleaginous base used in ovules may weaken rubber or latex products [eg, condoms, diaphragms]; using such products ≤72 hours after treatment with clindamycin ovules not recommended) OR
  • Secnidazole 2 g oral granules in a single dose OR
  • Tinidazole at 2 g PO once daily for 2 days OR
  • Tinidazole at 1 g PO once daily for 5 days