Treatment of bacterial vaginosis: What we have and what we miss

Gilbert Gg Donders, Jana Zodzika, Dace Rezeberga

Research output: Contribution to journalReview articlepeer-review

65 Citations (Scopus)


Introduction: The disturbing, foul-smelling discharge of bacterial vaginosis (BV) is a nuisance to women. Treatment possibilities for BV are limited and only achieve complete cure in 65 to 85% of cases. In most women, the condition relapses within weeks to months after treatment. Areas covered: In search of new therapeutic actions to cure, prevent or delay recurrences of BV, PubMed and web of science were searched for papers with i) decent study layout, ii) proper statistics, iii) comparison group (placebo or standard treatment) and iv) language English, French, Dutch or German. The following keywords were used: bacterial vaginosis and treatment or management or therapy or prophylaxis or prevention. Results were grouped in treatment categories and were discussed. Expert opinion: Clindamycin and metronidazole are the standard drugs for BV. As other antibiotic and acidifying treatments are progressively being studied, like tinidazole, rifaximin, nitrofuran, dequalinium chloride, vitamin C and lactic acid, more options have become available for switching therapy, combining therapies and long-term prophylactic use to prevent recurrences. Further studies are needed. Also, adjuvant therapy with probiotics may have a significant role in improving efficacy and in preventing recurrences. However, it is unlikely that probiotics will replace antibiotherapy.

Original languageEnglish
Pages (from-to)645-657
Number of pages13
JournalExpert Opinion on Pharmacotherapy
Issue number5
Publication statusPublished - Apr 2014


  • Abnormal vaginal flora
  • Aerobic vaginitis
  • Prophylaxis
  • Recurrent vaginitis

Field of Science*

  • 3.1 Basic medicine
  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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