This is dependent on the organism involved.
Women who have bacterial vaginosis or trichomoniasis, and who are also HIV-positive, should receive the same treatment regimen as those who are HIV-negative (1).
In non-pregnant women with bacterial vaginosis, oral or topical metronidazole or topical clindamycin are the treatments of choice.
Pregnant women can be safely treated with metronidazole and clindamycin is an effective alternative (1).
Metronidazole single-dose oral therapy has the lowest efficacy for bacterial vaginosis and is no longer recommended (2).
Non-pregnant women with trichomoniasis can be treated with multi-dose therapy with oral metronidazole or a single dose of tinidazole.
Pregnant women with trichomoniasis should be treated with multi-dose therapy with oral metronidazole, but tinidazole should be avoided (3).
For uncomplicated candidiasis infection, treatment with oral or topical azole antifungal agents should be started:
If atrophic vaginitis is the cause, topical oestrogen in women wishing to avoid hormonal treatment, or concomitant use of a lubricant in women on HRT may be adequate in controlling symptoms. (4)
In non-infective or allergic contact vaginitis, preventive measures are the mainstay of treatment (5).
References
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