1st stage of treatment.
Schemes of antibacterial treatment courses for bacterial vaginosis .
- Metronidazole – 500 mg x 2 times a day for 7 days;
- Ornidazole – 500 mg x 2 times a day for 5 days.
Alternative treatment regimens are possible .
- Metronidazole – 2.0 g orally once;
- Clindamycin per os – 0.3 g x 2 times a day for 7 days;
- Clindamycin – cream 2% 5.0g (single dose) intravaginally 1 time per day for 3 days;
- Metronidazole gel 0.75 % 5.0 g (single dose) intravaginally 2 times a day for 5 days.
- Dalacin — vaginal cream (2% clindamycin phosphate). The drug is available in tubes of 15 g with the attached 3 single applicators.
- Flagil — vaginal suppositories (derivative of nitro-5 imidazole ), 1 suppository for 10 days.
Combination products of local action (with antibacterial and antifungal activity)
- Terzhinan —- ( Ternidazole + Nystatin + Neomycin Sulfate + Prednisolone ) vaginal tablets. Appointed: 1 vagina . tablet at night, for 10 days; in case of confirmed mycosis, it can be increased up to 20 days. Do not stop treatment during menstruation.
- Klion- D — ( metronidazole 100 mg + miconazole nitrate 100 mg) vaginal tablets. With trichomonas vaginitis, 1 vaginal tablet is prescribed 1 time / day for 10 days in combination with oral metronidazole . In case of nonspecific vaginitis or candidal vaginitis, 1 vaginal tablet is prescribed 2 times / day for 10 days, if necessary in combination with metronidazole inside.
- Neo Penotran —- ( metronidazole 500 mg + miconazole nitrate 100 mg) suppositories. Assign a first suppository in the morning and a first suppository at night for 7 days, and for relapsing vaginosis within 14 days. The composition includes 100 mg of metronidazole and 100 mg of miconazole nitrate.
In some cases, exclusively local treatment is practiced, although its effectiveness is significantly lower than treatment with systemic drugs.
After the main combined course of treatment , a re-analysis of the smear from the vaginal secretion is performed.
2nd stage of treatment.
Treatment with probiotics is used only in the absence of candidiasis vulvovaginitis . At the 2nd stage of treatment of BV after an antibacterial course of treatment, it is necessary to apply: biological products ( eubiotics , probiotics ) to restore the normal microflora of the vagina and increase local immunity.
Therapy with probiotics .
Vaginal Probiotics . Probiotics containing vaginal acidophilic lactobacilli strains are
- Lactogin ( Vagilak ) —- 1 vaginal capsule for 10 days;
- Narine-Biosvechi (Armenia) —- 1 candle from 1-2 times a day for 5-10 days ;
- Lactobacterin dry on tampons by 2.5-3 —- dose 2 times a day. Before use, dilute the drug in 5 ml of boiled water. The course is 7-10 days.
- Acylact —- appoint 1 suppository 1-2 times a day at night for 5-10 days.
Of the preparations that do not contain bacterial strains, but improve the vaginal microflora , Vaginorm- C is known . These are vaginal ascorbic acid tablets. Gradually being released, ascorbic acid lowers the pH of the vagina to the physiological norm, thereby creating optimal environmental conditions for the growth and vital activity of lactobacilli .