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.