Bacterial Vaginosis Treatment — SCE Infectious Diseases MCQ

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EasySTIsBacterial Vaginosis TreatmentSCE Infectious Diseases

A 30-year-old woman with well-controlled HIV on ART develops bacterial vaginosis (BV). Vaginal microscopy shows clue cells. She reports fishy-smelling discharge. What is the first-line treatment for BV?

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Correct answer: E — Oral Metronidazole 400 mg BD for 5–7 days

Bacterial vaginosis is a polymicrobial dysbiosis (reduced Lactobacilli, overgrowth of Gardnerella vaginalis and anaerobes). It is NOT caused by a single STI pathogen. BV is treated identically in HIV-positive and HIV-negative women. Oral Metronidazole 400 mg BD for 5–7 days is first-line. Intravaginal Metronidazole gel or intravaginal Clindamycin cream for 5–7 nights are alternatives. Fluconazole treats Candida, not BV. BV increases HIV transmission risk and is associated with preterm birth in pregnancy.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/infections