Bacterial Vaginosis: The Daily PANCE Blueprint
A 31-year-old female presents to the clinic with worsening vaginal discharge that has a distinct fishy odor. You suspect bacterial vaginosis. Which of the following is the treatment of choice?
A. Doxycycline
B. Ceftriaxone
C. Metronidazole
D. Fluconazole
E. Supportive care
Answer and topic summary
The answer is C. Metronidazole
Vaginitis is defined by inflammation or infection of the vagina. Clinical features depend but may include: change in volume/odor/color of vaginal discharge, burning, irritation, erythema, dysuria, and pruritus. The most common cause is infectious (about 70-90% of the time): bacterial vaginosis (BV), vulvovaginal candidiasis, and trichomoniasis. Other non-infectious etiologies include foreign bodies, changes in estrogen levels, genital care products, pregnancy, antibiotic usage, and sexual activity. Work-up should including testing the abnormal vaginal discharge for BV, Candida species, and trichomonas. Specifically for BV, metronidazole is given as PO (500 mg BID x 7 days) or vaginal gel medication over multiple days.
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Covered under ⇒ PANCE Blueprint Reproductive System ⇒ ⇒
