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====First Line Therapy<ref name="CDC Sexually Transmitted Infections Treatment Guidelines, 2021">CDC Sexually Transmitted Infections Treatment Guidelines, 2021.[https://www.cdc.gov/mmwr/volumes/70/rr/pdfs/rr7004a1-H.pdf]</ref>====<br />
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*[[Special:MyLanguage/Metronidazole|Metronidazole]] 500 mg PO Twice Daily for 7 days OR<br />
*[[Special:MyLanguage/Metronidazole|Metronidazole]] gel 0.75%, one full applicator (5 g) intravaginally, Daily for 5 days OR<br />
*[[Special:MyLanguage/Clindamycin|Clindamycin]] cream 2%, one full applicator (5 g) intravaginally Nightly for 7 days<br />
Metronidazole does not cause a disulfiram-like reaction with alcohol.<ref name="Is combining metronidazole and alcohol really hazardous?">Is combining metronidazole and alcohol really hazardous?[http://www.ncbi.nlm.nih.gov/pubmed/25223673]</ref><br />
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====Alternative Regimin====<br />
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*[[Special:MyLanguage/Clindamycin|Clindamycin]] 300 mg PO BID for 7 days OR<br />
*[[Special:MyLanguage/Clindamycin|Clindamycin]] ovules 100 mg intravaginally qHS for 3 days (do not use if patient has used latex condom in last 72 hours)<br />
Other regimens have been studied and have varying efficacy compared to placebo but due to cost and availability do not represent alternatives outside of absolute contraindications to preferred regimens.<br />
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====Pregnant====<br />
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*[[Special:MyLanguage/Metronidazole|Metronidazole]] 500mg PO Twice a day x 7 days<ref name="CDC Sexually Transmitted Infections Treatment Guidelines, 2021">CDC Sexually Transmitted Infections Treatment Guidelines, 2021.[https://www.cdc.gov/mmwr/volumes/70/rr/pdfs/rr7004a1-H.pdf]</ref><br />
*[[Special:MyLanguage/Metronidazole|Metronidazole]] 250mg PO Three times a day has also been studied<ref name="Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis">Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis[http://www.ncbi.nlm.nih.gov/pubmed/7491136]</ref><ref name="Effect of metronidazole in patients with preterm birth in preceding pregnancy and bacterial vaginosis: a placebo-controlled, double-blind study">Effect of metronidazole in patients with preterm birth in preceding pregnancy and bacterial vaginosis: a placebo-controlled, double-blind study[http://www.ncbi.nlm.nih.gov/pubmed/8059811]</ref><br />
* Although metronidazole crosses the placenta, no evidence of teratogenicity or mutagenic effects among infants has been reported in multiple cross-sectional, case-control, and cohort studies of pregnant women<ref name="CDC Sexually Transmitted Infections Treatment Guidelines, 2021">CDC Sexually Transmitted Infections Treatment Guidelines, 2021.[https://www.cdc.gov/mmwr/volumes/70/rr/pdfs/rr7004a1-H.pdf]</ref><br />
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====Prophylaxis ([[Special:MyLanguage/Sexual Assault|Sexual Assault]])====<br />
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*[[Special:MyLanguage/Metronidazole|Metronidazole]] 500mg PO Twice a day x 7 days<ref name="Sexual Assault and Abuse and STIs – Adolescents and Adults">Sexual Assault and Abuse and STIs – Adolescents and Adults[https://www.cdc.gov/std/treatment-guidelines/sexual-assault-adults.htm]</ref></div>FuzzyBot