Bacterial Vaginosis: Medications

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Medications

The antibiotics metronidazole (such as Flagyl, MetroGel), clindamycin (such as Cleocin, Clindesse), and tinidazole (Tindamax) are used to treat bacterial vaginosis. Depending on the antibiotic you are prescribed, you may take it by mouth or use it vaginally.

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 show that vaginal antibiotics are as effective as oral antibiotics for treating bacterial vaginosis.⁹ Medicines inserted into the vagina cause fewer side effects than oral medicines, although they can make you vulnerable to vaginal yeast infection.

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

• Use oral medicine or medicine inserted into the vagina. Some women prefer to take pills rather than using a vaginal medicine.
• Avoid having sex during the time that you are being treated.
• Continue treatment during your menstrual period. Medicine placed in your vagina is more difficult to use during your period, but your doctor may recommend continuing treatment during this time.
• Avoid drinking alcohol during treatment with metronidazole or tinidazole. These medicines can cause severe nausea and vomiting if you drink alcohol when you are taking one of them. 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 medicine.

Last updated:	March 17, 2008
Author:	Caroline Rea, RN, BS, MS
Reviewed By:	Kathleen Romito, MD - Family Medicine, Jeanne Marrazzo, MD, MPH - Infectious Disease
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC