Medication
Other potential benefits of treatment include reduction in the risk for acquiring C. trachomatis, N. gonorrhoeae, T. vaginalis, M. genitalium, HIV, HPV, and HSV-2 ( 971, 986 – 988, 990, 1010 ). No data are available that directly compare the efficacy of oral and topical medications for treating BV.
Self-care
It is important that you take all of the medicine prescribed to you, even if your symptoms go away. A health care provider can treat BV with antibiotics, but BV may recur even after treatment. Treatment may also reduce the risk for some STDs. Male sex partners of women diagnosed with BV generally do not need to be treated.
Nutrition
But if you have symptoms of BV you should be checked and treated. It is important that you take all of the medicine prescribed to you, even if your symptoms go away. A health care provider can treat BV with antibiotics, but BV may recur even after treatment.
What are the benefits of treatment for bacterial vaginosis (BV)?
NPs need to be aware of the consequences of BV, which has been associated with postpartum fever, posthysterectomy vaginal cuff cellulitis, postabortal infection, and endometrial infection.
What should I do if I have BV?
Does BV go away on its own?
What are the possible complications of bacterial vaginosis (BV) in nurses?
What happens after treating BV?
Following BV therapy, a vaginal yeast infection may occur. If symptoms improve after treatment, a follow-up visit is not necessary. Metronidazole — Metronidazole vaginal gel is one of the most effective treatments; it is applied inside the vagina at bedtime for five days.
How long does it take for BV to clear up after treatment?
While the infection may go away on its own, most doctors use antibiotics to treat it. You may have been prescribed pills or vaginal cream. With treatment, bacterial vaginosis usually clears up in 5 to 7 days.
Can BV still be there after treatment?
BV often recurs, usually within a few months of treatment - although if any of the behaviours which can trigger it (such as using douches) apply to you then it may be less likely to recur if you avoid these things. BV often returns after it has been treated.
What happens if bacterial vaginosis doesnt go away after treatment?
Around a third of women who take antibiotic treatment for bacterial vaginosis (BV) find that the problem recurs within the next two to three months. Some strains of BV organisms may have resistance to some antibiotics. You should return to your healthcare provider and describe the problems you are having.
How long for BV smell to go away?
Once you start treatment with a simple course of antibiotics, the symptoms of bacterial vaginosis (BV) usually go away within two to three days.
How do I know if metronidazole is working?
by Drugs.com Metronidazole starts to work 1 to 2 hours after you take it, because it is quickly absorbed, and it reaches its maximum concentration after 20 minutes to 3 hours. But it may take a couple of days before you start to feel better or notice an improvement in your symptoms.
Can BV be cured permanently?
Yes, BV is usually curable with prescription antibiotics that can help readjust the balance of bacteria in the vagina. Although some over-the-counter vaginal medications are sold, these are not effective for curing BV. Currently, only prescribed antibiotics are effective.
What if BV keeps coming back?
It's common for BV to come back, usually within 3 months. You'll need to take treatment for longer (up to 6 months) if you keep getting BV (you get it more than twice in 6 months). A GP or sexual health clinic will recommend how long you need to treat it.
How long does BV take to go away with metronidazole?
Pregnant women with symptoms of BV infection are usually treated. Oral treatment with seven days of metronidazole is preferred over vaginal treatments. The best way to prevent BV is not known. However, a few basic recommendations can be made.
Is BV hard to get rid of?
Bacterial vaginosis often clears up on its own. But in some women it doesn't go away on its own. And for many women it comes back after it has cleared up. Antibiotic treatment works for some women but not others.
How do I get rid of BV when antibiotics don't work?
Probiotics, live bacteria found in some foods and supplements, might help restore balance to your vaginal bacteria. Studies show that eating yogurt or probiotic supplements may treat bacterial vaginosis, and is quite safe. Another promising remedy is boric acid, a white powder with antifungal and antiviral properties.
Why is metronidazole not working for BV?
Second, the bacteria that either cause BV or cause the anaerobic overgrowth may have become relatively more resistant to metronidazole (the most common treating agent) or to clindamycin (the other common treating agent).
Can bacterial vaginosis be cured?
BV will sometimes go away without treatment. But if you have symptoms of BV you should be checked and treated. It is important that you take all of the medicine prescribed to you, even if your symptoms go away. A health care provider can treat BV with antibiotics, but BV may recur even after treatment.
Resources for Clinicians
Vaginitis Self-Study Module external icon – An online learning experience that helps users learn how to manage vaginitis. Free CME/CNE available. (November 1, 2017)
What is the best treatment for BV?
Currently, the only effective treatments for BV are prescribed antibiotics, including metronidazole (pronounced met-roh-NIH-duh-zohl) and clindamycin (pronounced klin-duh-MY-sin ). 1, 2, 3, 4 These are prescribed as oral medications, which are taken by mouth, or as a gel or cream, both of which are inserted into the vagina with an applicator.
Why is it important to complete the entire course of a prescription for BV?
Even if symptoms start to disappear, it is important to complete the entire course of a prescription for BV because of the likelihood of recurrence.
How much weight can a pregnant woman have with BV?
Risks of BV during pregnancy include delivering an infant preterm (before 37 weeks of pregnancy) and delivering an infant with a low birth weight (generally, 5.5 pounds or less). The CDC recommends that pregnant women be tested—and treated if necessary—if they have symptoms of BV.
Does BV reduce preterm birth?
Some research shows that treating BV in pregnant women does not reduce the risk of preterm birth. Further study is needed to better understand these outcomes. 5
How to treat BV?
Bacterial vaginosis (BV) is usually treated with a course of antibiotics either taken by mouth or through an intravaginal applicator. 2 Boric acid suppositories also have a long history of use and have been shown to be effective. 3 They can be purchased over the counter.
How common is BV infection?
Chronic BV infections are very common, with some studies estimating that infections can recur in as many as 50% of women. When symptoms occur, talk to your doctor about the best method of treatment. How to Cope With and Prevent Bacterial Vaginosis.
What is the cause of vaginosis?
Bacterial vaginosis is caused when "good" vaginal flora, called lactobacilli, is depleted, allowing "bad" bacteria to predominate and cause infection. As such, it has been suggested that probiotics, rich in healthy bacteria like Lactobacillus acidophilus, may be useful in replenishing vaginal flora. However, the CDC says no studies support this, though researchers continue to investigate the role of lactobacillus formulations in BV treatment. 2
What is BV in vagina?
Updated on September 26, 2019. Bacterial vaginosis (BV) is a common vaginal infection that causes itchiness, vaginal discharge, and a characteristic "fishy" odor. Most cases are uncomplicated and may be treated with prescription antibiotic drugs, taken either orally or with topical creams or gels.
What is the best treatment for yeast infection?
Here is what we know: Boric acid has been used to treat yeast infections ( vaginal candidiasis) for over 100 years. A 2015 study explored its use as a vaginal suppository in women with BV and found that after 10 days, the rate of infection clearance was similar to that of antibiotics. 3. Hydrogen peroxide, delivered in a 3 percent intravaginal ...
How high is the rate of bacterial vaginosis?
Some studies have suggested that the rate may be as high as 50 percent ; others believe that it is much greater.
Is BV anaerobic or anaerobic?
The is due in part to the types of bacteria involved in BV (which are anaerobic and don't require oxygen) compared to those found in other forms of vaginitis (which are aerobic and do require oxygen).
How long does metronidazole last?
Recommended treatment for recurrent BV consists of an extended course of metronidazole treatment (500 mg twice daily for 10-14 days); if ineffective, metronidazole vaginal gel 0.75% for 10 days, followed by two times per week for 3-6 months, is an alternate treatment regimen.
Is BV a common disease?
Bacterial vaginosis (BV) is a common but treatable condition, with a number of effective available treatments, including oral and intravaginal metronidazole and clindamycin and oral tinidazole. However, as many as 50% of women with BV experience recurrence within 1 year of treatment for incident dis …
Is BV a treatable condition?
Bacterial vaginosis (BV) is a common but treatable condition, with a number of effective available treatments, including oral and intravaginal metronidazole and clindamycin and oral tinidazole. However, as many as 50% of women with BV experience recurrence within 1 year of treatment for incident disease. Some reasons for recurrence include the ...
What is the treatment for BV?
This lincosamide antibiotic, a subclass of the larger family of macrolide antibiotics, has various treatment preparations including vaginal (ovule and cream) and oral. Clindamycin vs placebo .
How to treat BV?
Another alternative for treating BV is to induce a vaginal flora shift from a BV- to a Lactobacillus-dominated flora by promoting the growth of lactobacilli. The principle behind prebiotics is to provide nutriments that stimulate the growth of lactobacilli. Oligosaccharides can selectively promote the growth of lactobacilli that in turn generate lactic acid to lower the vaginal pH and secrete antibacterial substances that inhibit the adhesion and replication of the anaerobic bacteria.74Some authors have proposed the topical application of a gel containing sucrose, a disaccharide of glucose and fructose, to treat BV. A Phase III clinical trial was conducted including women with symptomatic BV who were randomly assigned into three groups for vaginal application of sucrose (5 g), metronidazole (0.75%), and placebo gels, twice daily for 5 consecutive days.75The therapeutic cure rates (according to FDA guidelines) evaluated 21–35 days after the start of treatment were 61%, 67%, and 7%, respectively, for sucrose, metronidazole, and placebo gel groups. These results suggest that sucrose has a therapeutic cure rate similar to the metronidazole gel. Interestingly, at the intermediate visit (7–10 days after the start of treatment), the therapeutic cure rate was statistically higher for the sucrose group (83%) than for the metronidazole group (71.3%) and the placebo group (0.9%). The evaluation of lactobacilli based on the Nugent score at the 5–7 days visit showed significantly higher levels of lactobacilli in the sucrose gel group compared with the metronidazole group. These results suggest that by promoting the growth of lactobacilli, sucrose gel restores normal vaginal flora more rapidly than does metronidazole. However, while the rate of adverse events after sucrose gel was found to be similar with that found in the other groups, treatment with sucrose would be expected also to promote the development of candidosis.
What is BV in a vagina?
BV is characterized by the alkalinization of vaginal fluid (vaginal pH > 4.5) prompting some authors to propose correcting the vaginal pH in order to treat BV. The results have been discordant. In two randomized double-blind clinical trials, vaginal acidification alone (5 mL acetic acid gel intravaginally twice daily for 7 days or 5 g acid-buffering formulation gel intravaginally once daily for 5 days) was an ineffective therapy for BV compared with placebo or metronidazole.59,60However, in another randomized study, the combination of oral metronidazole 500 mg twice daily and 5 g lactic acid vaginal gel at bedtime for 7 days was found to be better than metronidazole alone at promoting lactobacilli colonization and reducing malodorous vaginal discharge.61Moreover, not only was the lactic acid well tolerated but it also reduced recurrence of symptomatic BV.61
What is BV in women?
Bacterial vaginosis (BV) is a common cause of malodorous vaginal discharge in women of reproductive age.1Women’s awareness of BV is low and often they self-medicate with antifungals before presenting very late when symptoms have become intolerable.
What essential oils are good for BV?
Essential oils from medicinal plants have strong antiseptic properties. Two recent studies have suggested the use of thymol and eugenol for BV therapy.69,70Thymol is a natural monoterpene phenol found in oil of thyme, with an in vitro activity on G. vaginalisbiofilms; and eugenol is a phenylpropene extracted in particular from clove oil. Both were applied via vaginal douche once daily for 7 days and resulted in a similar significant reduction in symptoms as that obtained with vaginal metronidazole.70Beyond reducing symptoms, the effect of thymol on vaginal flora should however be analyzed.
Is tinidazole a good drug for BV?
Based on its pharmacokinetic profile, tinidazole has the potential of being a highly efficacious drug for BV. Compared with metronidazole, it has a higher Cmax, area under the curve, and steady-state serum concentration, and longer half-life.33The spectrum of activity against bacteria associated with BV is very similar for the two agents.33The efficacy of two regimens of tinidazole (500 mg twice daily or 1 g twice daily for 7 days) was compared with metronidazole 500 mg twice daily for 7 days in a randomized trial.34No significant difference was found in treatment failure rates (Nugent score ≥7) between tinidazole (27% for the 1 g regimen and 25% for the 500 mg regimen) and metronidazole (18%) at the 14-day follow-up visit. Similarly, short-term recurrence rates at the 2-month follow-up visit were not significantly different (40%, 20%, and 34% respectively).
Can probiotics be used for BV?
Other authors have proposed the prophylactic use of probiotics in healthy women with a history of recurrent BV. A randomized, double-blind, placebo-controlled trial was conducted among healthy women who had suffered >2 BV episodes in the previous year.58The women were randomized to receive either one vaginal capsule of probiotics (8 billion colony forming units of L. rhamnosus, L. acidophilus,and Streptococcus thermophilus) or placebo on a 7 days on, 7 days off, 7 days on regimen. Lower rates of BV incidence were reported during the 2 months after probiotic prophylaxis (16% for the probiotic and 45% for the placebo group) according to Amsel’s criteria. The 11-month follow-up consisting of a telephone interview suggested that women receiving probiotics had a lower incidence of BV symptoms than did those in the placebo group. Although this study was limited by the telephone follow-up interview that may have under-reported the frequency of BV symptoms, the results do suggest that local administration of Lactobacillusstrain could therefore be a useful complementary tool in the management of recurrent BV. Other studies are now needed to validate further the efficacy of probiotics in the prevention of recurrent BV.
How to treat BV?
24 Interventions include boric acid vaginal suppositories for 21 days followed by 0.75% metronidazole gel twice weekly for 4 to 6 months. 8,9 Caution must be exercised as boric acid can cause death if ingested orally; patients should be instructed to store it in a secure place out of reach of children . Hormonal contraception may have beneficial effects on vaginal epithelial cells. 22 BV-related microbes have been found in the male genitalia, however, studies evaluating concurrent treatment of male sexual partners of women with BV have failed to demonstrate benefit so this is not recommended. 25
What are the consequences of BV?
NPs need to be aware of the consequences of BV, which has been associated with postpartum fever, posthysterectomy vaginal cuff cellulitis, postabortal infection, and endometrial infection. BV increases the risk of contracting sexually transmitted infections including HIV, herpes simplex virus type 2 (HSV-2), gonorrhea, chlamydia, and trichomonas infection. 15,17,18
What age group is most likely to have bacterial vaginosis?
Figure. According to the CDC, bacterial vaginosis (BV) is one of the most common vaginal disorders in women ages 14-49. 1 Estimated BV occurrence in women ...
What is the shift in vaginal flora?
However, in BV, there is a shift in vaginal flora, with a reduction in the dominant Lactobacillus species and an overgrowth of anaerobic pathogens such as Gardnerella vaginalis, Mobiluncus species, and Mycoplasma hominis, and a subsequent elevation in pH.
What is the pathophysiology of BV?
Pathophysiology. The pathophysiology of BV is characterized by a modification in the vaginal bacterial flora and is poorly understood. Under normal circumstances, Lactobacilli are found in high concentrations in the vagina.
How to diagnose BV?
The diagnosis of BV is easily accomplished in an outpatient office setting based upon Amsel criteria, which requires microscopy and is not complicated to perform. 19 Clinics without microscopes are unable to perform the Amsel criteria method. The Amsel criteria requires vaginal discharge sampling with speculum examination. Three out of four criteria must be present to make an accurate diagnosis (see Amsel diagnostic criteria ). NPs should be cautious about making the diagnosis based on patient-reported symptoms, such as a “fishy odor,” which may guide differential diagnosis but does not establish a definitive diagnosis. 2 The “whiff test” is considered positive if the application of potassium hydroxide solution to the vaginal sample on a wet mount renders a fishy odor. Patient self-report of fishy-smelling discharge does not signify a positive whiff test. NPs utilizing Amsel criteria must be competent in the use of a microscope to identify clue cells.
What are the factors that increase the risk of BV?
Certain factors can increase a woman's risk for BV: Smoking: Tobacco is thought to alter the physiology and structure of the flora of the vagina, increasing bacterial virulence. Nicotine metabolites have been found in the cervical mucous of female smokers.
Prescriptions
Home Remedies
Pregnancy Recommendations
Antibiotic Resistance
Specialist to consult
Complementary Medicine