Bacterial Vaginosis - Medications

Medications

Antibiotics are the standard treatment for bacterial vaginosis. Metronidazole (Flagyl; MetroGel) and clindamycin (Cleocin; Clindesse) are the first-choice medications for treating bacterial vaginosis. For women who cannot tolerate metronidazole, the broad-spectrum antibiotic clindamycin is a good option.

These antibiotics can be given by mouth (orally) or inserted into the vagina. During pregnancy, women who are high-risk for preterm labor are advised to avoid vaginal application of any treatment. Some doctors recommend that all pregnant women avoid vaginal treatments.

Studies generally indicate that vaginal antibiotics are as effective as oral antibiotics for treating bacterial vaginosis.¹⁰ Medications inserted into the vagina cause fewer side effects than oral medications, although they can make you vulnerable to vaginal yeast infection.

When considering treatment for bacterial vaginosis, ask your health professional whether you should:

• Use oral medication or medication inserted into the vagina. Some women prefer taking pills to using a vaginal medication.
• Avoid having sex during treatment.
• Continue treatment during your menstrual period. Medication placed in your vagina is more difficult to use during your period, but your health professional may recommend continuing treatment during this time.
• Avoid drinking alcohol during treatment with metronidazole. This medicine can cause severe nausea and vomiting if you drink alcohol when taking it. Clindamycin does not.

The mineral oil in clindamycin cream or ovules can cause latex condoms or diaphragms to fail. This is also true for metronidazole cream and tablets (the gel is fine for use with condoms and diaphragms). Don't trust barrier methods of birth control when using this type of vaginal medication.