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Uptodate Reference Title
Initial treatment of bacterial vaginosis
Initial treatment of bacterial vaginosis
Treatment of sexual partners varies by anatomy and symptoms. Sexual partners with a vagina or neovagina are treated if symptomatic. Sexual partners with a penis or neophallus do not require antibiotic treatment.
BV: bacterial vaginosis. * We do not routinely treat asymptomatic individuals, including pregnant and lactating persons. However, others may reasonably elect to treat asymptomatic pregnant individuals as the supporting data conflict, particularly for those with a history of preterm birth. ¶ As treatment efficacy is similar between metronidazole and clindamycin, the choice of medication is based on availability, patient preference, side effects, cost, and history of response or adverse reactions. Δ For additional treatment options, please refer to related UpToDate content on treatment of bacterial vaginosis. ◊ Pregnant individuals who are unable to tolerate metronidazole 500 mg twice daily because of gastrointestinal symptoms may be able to tolerate metronidazole 250 mg three times daily. § Breastfeeding infants may develop side effects from maternal clindamycin treatment and should be monitored for possible symptoms, including diarrhea, candidiasis (thrush, diaper rash), or rarely, colitis.
