Bacterial vaginosis
The regional formulary will not cover all eventualities for infections medicines choices. As with any condition; patient specific factors and sensitivities need to be considered. Please consider this regional formulary advice alongside any relevant local Board guidelines.
Treatment of bacterial vaginosis
Topical treatment with either metronidazole or clindamycin, or oral metronidazole.
Metronidazole
Metronidazole 400mg tablets
400mg every 12 hours for 5 days or 2g stat.
Metronidazole 0.75% vaginal gel
One applicatorful daily for 5 days, dose to be administered at night.
Clindamycin
Clindamycin 2% vaginal cream
One applicatorful daily for 3 to 7 nights, dose to be administered at night.
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.
- Relapse is less frequent with 5-day treatment of metronidazole than STAT dose.
- Bacterial vaginosis reflects altered vaginal flora; recurrence is frequent.
- Clindamycin cream can weaken condoms.
- With any genital symptoms consider a sexually transmitted infection (STI) test including chlamydia, gonorrhoea, HIV and syphilis.
History Notes
30/07/2026
Regional formulary chapter launched.