Gardnerella
Background[1]
- Gram variable coccobacilli implicated as a factor in bacterial vaginosis
- Facultative anaerobe
- Non-spore forming
Clinical Features[2]
- See bacterial vaginosis
- Spectrum of asymptomatic to malodorous whitish-gray vaginal discharge
- Clue cells with bacteria on surface of vaginal epithelial cells on wet mount
- Bacterial vaginosis is a multi-organism dysbiosis
- G. vaginalis can be isolated in healthy vaginal microbiome but is not the dominant species
Antibiotic Sensitivities[3]
- Please reference your updated local antibiogram
- Primary Regimens:[4]
- Metronidazole 500 mg PO BID x7 days
- Single dose metronidazole no longer recommended
- Metronidazole 0.75% gel one applicator (5 g) intravaginally daily x5 days
- Clindamycin 2% vaginal cream one applicator (5 g) intravaginally nightly x7 days
- Clindamycin 300 mg PO BID x7 days
- Metronidazole 500 mg PO BID x7 days
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
Table Overview
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See Also