Treatment regimens used in studies demonstrating a reduction in preterm birth in treated high-risk patients with bacterial vaginosis

Metronidazole 400 mg orally twice daily for 2 consecutive days. Repeat if a second test 4 weeks post-treatment is positive.^[1]

Metronidazole 250 mg orally 3 times daily for 7 days plus erythromycin base 333 mg orally 3 times daily for 14 days. Repeat test at 28 weeks of gestation and repeat treatment if test is positive.^[2]

Metronidazole 250 mg orally 3 times daily for 7 days. No second treatment.^[3]

Clindamycin 300 mg orally twice daily for 5 days. No second treatment.^[4]

Clindamycin 5 grams of 2% vaginal cream nightly for 3 nights. Repeat test 3 weeks after initial diagnosis; if still positive, give a 7-day course of the same treatment.^[5]

References:

McDonald HM, O'Loughlin JA, Vigneswaran R, et al. Impact of metronidazole therapy on preterm birth in women with bacterial vaginosis flora (Gardnerella vaginalis): a randomised, placebo controlled trial. Br J Obstet Gynaecol 1997; 104:1391.
Hauth JC, Goldenberg RL, Andrews WW, et al. Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis. N Engl J Med 1995; 333:1732.
Morales WJ, Schorr S, Albritton J. Effect of metronidazole in patients with preterm birth in preceding pregnancy and bacterial vaginosis: a placebo-controlled, double-blind study. Am J Obstet Gynecol 1994; 171:345.
Ugwumadu A, Manyonda I, Reid F, Hay P. Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomised controlled trial. Lancet 2003; 361:983.
Lamont RF, Duncan SL, Mandal D, Bassett P. Intravaginal clindamycin to reduce preterm birth in women with abnormal genital tract flora. Obstet Gynecol 2003; 101:516.

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Treatment regimens used in studies demonstrating a reduction in preterm birth in treated high-risk patients with bacterial vaginosis