Bacterial vaginosis: Difference between revisions
No edit summary |
No edit summary |
||
Line 20: | Line 20: | ||
{{BV Metronidazole Adult}} | {{BV Metronidazole Adult}} | ||
{{BV Clindamycin Adult}} | |||
{{BV | |||
==See Also== | ==See Also== |
Revision as of 16:41, 19 April 2015
Background
- Accounts for up to 50% of cases of vaginitis
- Associated w/ preterm labor and premature rupture of membranes
- Treat all symptomatic women (including pregnant)
- Do not treat asymptomatic women (including pregnant)
Diagnosis
- whitish-gray discharge and odor
- Lack of discharge makes diagnosis less likely
- Wet mount shows clue cells: bacteria that line the borders of the vaginal epithelial cells
- Whiff Test: fishy odor with 10% KOH added
Differential Diagnosis
Vulvovaginitis
- Bacterial vaginosis
- Candida vaginitis
- Trichomonas vaginalis
- Contact vulvovaginitis
- Atrophic vaginitis
- Lichen sclerosus
- Tinea cruris
- Chlamydia/Gonorrhea infection
- Vaginal foreign body
Treatment
- Do NOT need to treat sexual partner
- 2 Options: Metronidazole or Clindamycin
Antibiotics
- Metronidazole 2g PO once
<45kg
- 15 mg/kg/day PO divided q8h x 7 days
- First Dose: 7 mg/kg PO x 1
>45kg
- 2 g PO x 1
Pregnancy
- Alternative: 250mg PO q8h x 7 days in pregnant patients[1]
- 2g PO x 1 is also acceptable in pregnancy[1]
- Multiple studies have not demonstrated teratogenicity from metronidazole use[1]
Prophylaxis (Sexual Assault)
- Metronidazole 2 g PO x 1 OR
- Clindamycin 300mg PO BID x 7 days