Bacterial vaginosis

Prescribing Notes:

• Offer self-care advice to minimise contributing factors, e.g. reduce exposure to vaginal douching and the use of antiseptics, bubble baths, or shampoos in the bath. A trial of lactic acid vaginal gel may be considered, a proprietary preparation (Relactagel) is available for sale to the public.
• Relapse is less frequent with 7-day treatment of metronidazole than STAT dose.
• Bacterial vaginosis reflects altered vaginal flora; recurrence is frequent but this is not a sexually transmissible condition and treatment of the sexual partner is not necessary.
• Clindamycin cream can weaken condoms.
• With any genital symptoms always consider the possibility of sexually transmitted infection (STI). People with risk factors should be screened for chlamydia, gonorrhoea, HIV and syphilis. Refer the individual and partners to the sexual health service. Risk factors: younger patient, a new sexual partner or more than one sexual partner in the past year, lack of consistent condom use and a contact of a sexually transmitted infection.