Metronidazole Vaginal Gel For Bacterial Vaginosis

It works by killing bacteria or preventing their growth. You may report side effects to Health Canada at 1-866-234-2345. In JS Berek, ed. Swallow the extended-release tablet whole. Reliance on any information provided by LifeScript is solely at your own risk. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

One 150-mg tablet orally once per week TABLE 5 Selected Regimens for Recurrent Vulvovaginal Candidiasis Treatment Initial dosage Maintenance dosage Clotrimazole 100-mg vaginal tablet (100 mg, Gyne-Lotrimin, Mycelex-7; 500 mg, Mycelex-G) One 100-mg tablet intravaginally per day for 7 days One 500-mg tablet intravaginally once per week Fluconazole (Diflucan) One 150-mg tablet orally; repeat after 3 days. Data saturation was not reached at the target sample of 20 women, so interviewing continued to a total of 33 participants at which time saturation had been reached. Some researchers think it is possible that a change in sexual partners can upset the pH balance of vaginal bacteria. It’s easy, a little less embarrassing, and you don’t have to wait long for an appointment. A recent study looked at over 900 women who had taken metronidazole sometime during their pregnancy and there was no increased risk for preterm birth (birth before 37 weeks), low birth weight, or congenital anomalies. Buy pathfinder adventure path: strange aeons part 2, the lyrakien is a fantastic flier at 80 foot speed and perfect maneuverability. Adults—Dose is based on body weight and must be determined by your doctor.

Unfortunately, there is a high rate of recurrence after therapy.

These results contrast with studies that report an increase in the proportion of Lactobacillus species over the menstrual cycle and that of non-Lactobacillus species at menses [37, 38]. 1,2 A search was performed using Dialog DataStar for articles published between 1966 and September 2020, using the keywords bacterial vaginosis, recurrent bacterial vaginosis, vaginal pH, vaginal lactobacilli, probiotics, and bacteriotherapy. Metronidazole – This medication may also be called Metrogel-Vaginal or Flagyl. In two instances, the participants postponed taking the treatment for a few days as it did not fit with her social life plans.

There is also a change in vaginal flora from the normal lactobacilli (LB) dominant to flora with greatly reduced numbers of LB and an overgrowth of Gardnerella vaginalis, Mycoplasma hominis, and anaerobic bacteria such as peptostretococci, Prevotella spp, and Mobiluncus spp. In a more recent study [22], an aggressive antibiotic treatment combined with lactobacilli gave a cure rate of 75 % and 65 % after 6 and 12 months respectively. A healthy vagina has numerous organisms that naturally live there.


This is not an indication of a security issue such as a virus or attack. These results suggest difficulties to maintain long-term colonisation with administered lactobacilli. A National Institutes of Health study found that pregnant women with BV were more likely to deliver a baby with low birthweight than those without the infection. Metronidazole vaginal will not treat a vaginal yeast infection. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Pregnant women in their first trimester should avoid Flagyl. Yeast infection: symptoms, causes, diagnosis, and treatment, a blood clot may go away naturally, but a DVT requires anticoagulant treatment because it can become life threatening if the clot travels to the lungs and causes a PE. They described how it affected their mental wellbeing by making them feel depressed, increasing their anxiety and self-consciousness and for one, as a ‘life sentence’. However, you may be more likely to contract this infection if you have recently had sex with a new partner.

  • Metronidazole also comes as a topical gel.
  • Drugs for sexually transmitted infections.
  • Clindamycin (Cleocin, Clindesse, others).
  • Microscopy showed restoration to normal flora from asymptomatic BV in 37% women receiving LB treatment compared with 13% receiving placebo.
  • But changes in the balance of the different kinds of bacteria in your vagina can lead to bacterial vaginosis (BV).

What Increases Your Risk

7 percent of women who self-diagnosed yeast infection. This is not a complete list of possible side effects. The advice sought from online forums “of women miserable because BV has ruined their life” (V8, aged 25: )I keep getting yeast infections. Is it normal to bleed after sex?, hormone changes related to menopause , such as atrophic vaginitis . It will not work for colds, flu, or other viral infections. Washing habits varied from several times per day due to religious beliefs or to remove BV discharge, or commonly twice per day or every few days to weekly (to ‘preserve the natural body oils’).

Simply put, after you take the antibiotic, the infection is terminated and the symptoms disappear. There is a definite sexual correlation to this “non-oxygen liking bacteria takeover” down there. Although women felt antibiotics treat BV effectively, and were associated with longer time periods between episodes, they generally preferred using the lactic acid gel because of ease of use, once daily application and less side-effects. Sexual activity has been shown to affect colonisation by exogenous or endogenous lactobacilli [34, 35]. Women with bacterial vaginosis at the time of an invasive vaginal procedure have an increased risk of developing more serious infection or inflammation, such as pelvic inflammatory disease (PID) or endometritis.

One hypothesis claims that when these levels become unbalanced, certain microorganisms may overtake the normal flora leading to a low-grade infection that often produces an abnormal vaginal discharge. The over-the-counter therapies do work well for one-time or “occasional-time” infections provided they are yeast. As previously reported, relapse of BV was strongly associated with a change of sexual partner during the follow up [22]. Metronidazole gel for the vagina comes with a special applicator. Watch for symptoms such as itching or discharge during or after treatment with metronidazole vaginal. 10 Although other treatments have been shown to have approximately equivalent efficacy,11–16 they are associated with higher recurrence rates. Yeast infections affect the folds of the vagina and vulva and can cause discomfort, odor, and a thick white discharge.

  • Considering this, and in order to improve the persistence of EcoVag® strains, we modified our treatment protocol in trial II by increasing the EcoVag® dose to 10 days after antibiotic treatments followed by administration of EcoVag® capsules once weekly for four months.
  • It should be treated with either oral antibiotics that go after non oxygen liking bacteria (Flagyl) or vaginal creams that contain the same antibiotic (Metronidazole) or the antibiotic Clindamycin.
  • I have found that the number of women returning with recurrent BV has dropped dramatically.
  • Two women did not have access to a shower at their residence and used a bath or container to wash.
  • The decision to not treat was also evident amongst several women who felt poor prior treatment outcomes lessened their confidence in a cure.
  • There are many reasons why people have trouble taking their medicine.


Sacks may have uncovered a previously unreported resistance of organisms to metronidazole. 39 When trichomoniasis is found during routine Pap testing, management should be based on the pretest probability of infection in the patient, which is determined by the prevalence of T. Frequent or painful urination, wear underwear that is all cotton or has a cotton crotch. There is an increased risk for a man who has not been circumcised however, with proper hygiene this risk is reduced. This medicine can affect the results of certain medical tests.

Knowledge of a patient preference for topical lactic acid gel therapy despite lower perceived effectiveness may be useful for clinicians when making treatment decisions. Various approaches for the treatment of BV have been applied but recurrence has remained a major challenge. Codes were based on interview questions and subsequent emergent themes, checked by FG via inter-coded reliability for inferences and interpretation of data. Push the suppository (blunt end first) gently into your rectum (back passage).


“I prefer not to take medication if I don’t have to. Several drops of a potassium hydroxide (KOH) solution are added to a sample of vaginal discharge to find out whether a strong fishy odor is produced. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. Vaginal yeast infection, nearly three out of four women have had at least one. Interview recruitment continued until data saturation. Using this medicine with any of the following is not recommended. Metronidazole belongs to the class of medicines known as antibiotics. On occasion however, it may require long-term or repeat treatments.

Monistat may also interact with oral antibiotics or drugs that suppress the immune system. 5%, trichomoniasis only; and 0. In severe infections, redness, swelling, or cracks form in the walls of the vagina. This information should not take the place of medical care and advice from your health care provider. Bacterial vaginosis may be found during a pelvic exam. Most women opt for a visit to a gynecologist, but a primary care physician can also diagnose infections. 7,10 These findings lead onto the next question about aetiology.

Vaginal Medicine

Typically, the symptoms occur in your hands and feet. However, Flagyl doesn't tend to cause antibiotic-associated diarrhea—in fact, it may be a treatment for it. It does not take the place of talking to your doctor or pharmacist. Treating your male partner isn't necessary, however, since studies find it doesn't help prevent another infection. If the medicine upsets your stomach, it is best to take it with a meal or snack. Candida infections and their prevention, immune deficiency. Metronidazole is usually used as a single dose at bedtime (Nuvessa) or once daily for 5 consecutive days at bedtime (MetroGel Vaginal, Vandazole). If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor.

Talk to your health care professional about this risk and be sure to alert him or her if you experience severe diarrhea, stomach cramping or blood in your stool while taking clindamycin or within a few weeks of stopping it.


With prescription medication, such as Diflucan a yeast infection should go away in seven to fourteen days. Metronidazole can cause unusual results with certain medical tests. Recurrent yeast infections may require prescription of an oral antifungal medication. 35 Selected long-term regimens are listed in Table 5. Some babies may also develop a yeast infection (diaper rash or thrush). Triggers of BV were attributed to personal hygiene habits–soaps used to wash the vagina and sexual practices such as unprotected sex.


Laboratory tests to detect signs of bacterial vaginosis may include: Candida is a microorganism that is common in your body and can be found in small amounts throughout the areas of your body such as your mouth, intestines, skin, and vagina. In these cases the over-the-counter medications obviously won't work. But smell has gone. Both men and women with autoimmune issues like HIV are more prone to get a yeast infection because of their compromised immune system. The consumption of alcohol has to be avoided in all circumstances during, and up to 2 weeks, after treatment.

The cure rate at 6-month improved from 46 % to 65 % in women receiving EcoVag®, a nearly 20 % difference. In trials comparing treatments, cure rates for metronidazole 400 mg or 500 mg twice daily for 7 days have been equivalent to clindamycin vaginal cream daily for 3–7 days, and to metronidazole vaginal gel once or twice per day for 5 days. He is an NIHR Journals Editor and associate editor of Sexually Transmitted Infections journal. If, however, your yeast infection is recurrent and severe, you and your doctor might consider a single dose of Diflucan, followed by another pill 72 hours later, or you can take a 10-day course daily with a weekly suppressive dose (of 150 mg) for the following six months. Why does excessive douching increase the risk of developing BV? It’s also affordable as your insurance will cover the cost of the appointment.

This product is not intended to diagnose, treat, cure or prevent any disease. Some home treatments may be more effective for you than others. Many women commonly mistake other vaginal infections for Yeast Infections, believing that it is the most common type.

  • Use of Flagyl suppositories with condoms or diaphragms may increase the risk of rupturing the contraceptive device and hence make it ineffective.
  • This test detects the genetic material ( DNA ) of bacterial vaginosis bacteria.
  • Peripheral neuropathy may not go away after you stop taking metronidazole.
  • Ask your healthcare professional how you should dispose of any medicine you do not use.

What is the most important information I should know about metronidazole vaginal?

Do not stand or sit up quickly, especially if you are an older patient. Benign disorders of the vulva and vagina. One cause of recurrent BV may be that even after the harmful bacteria that replaced the "good" bacteria is gone, the "good" bacteria have trouble growing back in the vagina. Oligonucleotide probes. It is worth remembering that antibiotics do not work on viral infections, such as a cold or the flu. Antimicrobial treatments for bacterial vaginosis (BV) are effective, but taking lactobacillus tablets alongside metronidazole antibiotic therapy increases effectiveness over taking this antibiotic alone, according to a Cochrane Systematic Review.

What happens if I overdose? If you forget to use the gel, use it as soon as you remember. Your symptoms may improve before the infection is completely cleared. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Because of concerns about teratogenicity, many physicians hesitate to use oral metronidazole in women who are in the first trimester of pregnancy. Two studies reported higher cure rate (69 and 91 %) at 12-months in women treated with antibiotic and adjuvant lactobacilli but only women using natural method of contraception were included suggesting that they were probably engaged in a more stable relationship and less prone to change of partners and relapses [21, 42]. We asked women about their preferences, and the advantages and disadvantages of either treatment. The vaginal pH was <4.

Mutagenesis And Carcinogenesis

Another woman simultaneously sought treatment at two healthcare facilities, taking both the lactic acid gel and antibiotics at the same time. But in most cases, there is something you can do. The authors suggested more intensive treatment might have improved this.

Corresponding Author

Beware of self-diagnosis and treatment. Skipping doses can increase your risk of infection that is resistant to medication. The vast majority—about 95 percent—belong to a type of bacteria called lactobacillus.

Clindamycin – Also known as Clindesse or Cleocin, this medication comes as a cream. Flagyl can be taken by itself, or it can be taken with meals. Itching down there isn’t always a yeast infection – health essentials from cleveland clinic. The risk of antibiotic drug resistance was a common concern. Studies show that vaginal issues often occur when vaginal pH is unbalanced. Currently there is no evidence to suggest that metronidazole places a pregnancy at risk at any stage. If left untreated, a yeast infection in a man may go away on its own. Metronidazole (met-roe-NYE-da-zole) is an antibiotic used to treat infections.

One thing you can (and should) avoid doing: They found that 53 and 26 % of the women were colonised by any of the strains after the first and second menstruation following administration of lactobacilli [30]. However, there can be complications such as the infection spreading to the buttocks, scrotum, and inner thighs. Reasons given for preference of lactic acid gel were multiple. Remove the entire foil/plastic wrapper from the suppository. The presence of small gram-negative rods or gram-variable rods and the absence of longer lactobacilli on a Gram stain of the vaginal discharge also is highly predictive of bacterial vaginosis. I often find that one of those organisms is responsible for the infection, requiring completely different treatment.