Draft Study Notes: Pathophysiology of Bacterial Vaginosis
Pathophysiology of Diagnosis (3 of or gram stain)
- White vaginal discharge coating the vaginal wall, and its pathophysiology of bacterial vaginosis
- A ph of above 4.5
- Whiff test/ fishy odor
- Clue cells- coccoid bacteria
Treatment
- Symptomatic- treat
- Asymptomatic- only pg women preparing for termination
First choice: Metronidazole oral 500 mg, metronidazole gel, > similar effectiveness
- alcohol (avoid during and one day after completion) use may lead to disulfiram-like reactions
- clindamycin cream> less effective than met, oil-based hence weaken latex condoms and diaphragms,
- probiotics- controversial with no reliable evidence
- treatment of both partners- no evidence to support use hence not recommeneded
Pregnant women: associated with premature rapture of membranes, preterm labor, and postpartum endometriosis >screen when pg dgx is made. Use oral metronidazole recommended as opposed to topical
- Relapse and reinfection: (3 episodes with 12 months)
- Suppressive therapy- met gel (0.75%) for 4-6 months
- Vaginal boric acid 600 mg for 21 days + metronidazole for seven days
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