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Chapter 5: Infections
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Principles of antibacterial treatment
Coronavirus disease (COVID-19)
Eye infections
Gastro-intestinal tract infections
Genital tract infections
Meningitis
Oral and dental infections
Respiratory tract infections
Skin and soft tissue infections
Urinary tract infections (UTI)
5.1 Antibacterial drugs
5.2 Antifungal drugs
5.3 Antiviral drugs
5.4 Antiprotozoal drugs
5.5 Anthelmintics
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Management of bacterial vaginosis (BV)
First Line
Second Line
Specialist
Hospital Only
Oral metronidazole is as effective as topical treatment. There is less relapse at 4 weeks with 7 days treatment than with 2g single dose.
Topical treatment gives similar cure rates but is more expensive. Vaginal preparations are unsuitable for use during menstruation.
Treating partners does not reduce relapse. Refer to GUM if recurrent.
Metronidazole
- 400mg every 12 hours for 7 days or
- 2g single dose stat (avoid if pregnant or breastfeeding)
Metronidazole vaginal gel 0.75%
- One applicatorful (5g) inserted into the vagina once daily at bedtime for 5 consecutive nights
Clindamycin vaginal cream 2%
- One applicatorful (5g) inserted into the vagina once daily at bedtime for 7 consecutive nights
- In patients for whom a shorter treatment course is desirable, a 3 day regimen has been shown to be effective
See section 7.2.2 Vaginal and vulval infections
