Vaginitis: antibiotic therapy recommendations

Home back Drug Search Drug Tables disclaimer IV Dilutions Medline Renal Dosing

calculators General links *Health topics* consumer links News online store

Multimedia Library

More Health Topics

Vaginitis

Possible therapeutic alternatives

Vulvovaginal candidiasis:

Candida sp.

Oral alternatives:

Fluconazole 150mg orally as a one-time dose or Itraconazole 200mg orally twice daily for 2 doses.

Topical alternatives:

butoconazole (Femstat):insert one applicatorful intravaginally at bedtime x 3-6 days [2% cream 28g]

Clotrimazole (mycelex, Gyne-Lotrimin): 1 applicatorful at bedtime for 7 days. //Alternatively, 1 vaginal tab (100mg) intravaginally at bedtime for 7 days or 1 (500mg) vaginal tab x 1. [ supplied: 100, 500mg tablets, 1% vaginal cream-45 & 90 grams]

Miconazole (Monistat)   1 applicatorful intravaginally at bedtime for 7 days. Alternatively, Insert one 200mg vaginal suppository at bedtime for 3 days.

Terconazole (Terazol): 1 applicatorful (0.4%) intravaginally at bedtime for 7 days or (0.8%) at bedtime for 3 days. Alternatively, 80mg vaginal suppository at bedtime for 3 days.

Trichomoniasis (malodorous yellow-green discharge)

Trichomonas vaginalis

Flagyl 2 grams orally as single dose or Flagyl 500mg orally twice daily for 7 days.

Treatment failures:

retreat with Flagyl 500mg orally twice daily for 7 days.

Treat sex partners with Flagyl 2 grams x 1 or 500mg orally twice daily for 7 days

Bacterial vaginosis
( Malodorous vaginal discharge. Over half of the cases are asymptomatic.)

Common pathogens

Flagyl 500mg orally twice daily for 7 days or

Metrogel: 1 applicatorful intravaginally once daily at bedtime or twice daily (morning and evening) for 5 days. [70g tube 0.75% gel] or

Clindamycin 300mg orally twice daily for 7 days or

clindamycin 2% vaginal cream 5 grams intravaginally at bedtime for 7 days.

Antimicrobial Series
References

American Hospital Formulary Service. Drug Information. Bethesda, MD: ASHP, 1997.

Baden LR, Eisenstein BI.Impact of Antibiotic Resistance on the Treatment of Gram-negative Sepsis.
Curr Infect Dis Rep. 2000 Oct;2(5):409-416.

Bartlett JG et al. Community-acquired pneumonia in adults: guidelines for management. Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 1998;26:811-38.

Bartlett JG: Empirical therapy of community-acquired pneumonia: macrolides are not ideal choices. Semin Respir Infect 1997 Dec; 12(4): 329-33

Bartlett JG.1998 Pocket Book of Infectious Disease Therapy., Ninth Edition. Baltimore,MD: Williams&Wikins,1998.

Bernstein JM: Treatment of community-acquired pneumonia--IDSA guidelines. Infectious Diseases Society of America. Chest 1999 Mar; 115(3 Suppl): 9S-13S

Drug Information Handbook, 5th Ed. 1997, Lexi-Comp inc.

Ewig S et al. Pneumonia acquired in the community through drug-resistant Streptococcus pneumoniae. Am J Respir Crit Care Med. 1999;159:1835-42.

File TM Jr. Community-acquired pneumonia: recent guidelines for therapy. J Respir Dis. 1999;20:534-41.

Gilbert DN, Moellering RC, Sande MA. The Sanford Guide to Antimicrobial Therapy 2000. 30th ed. Hyde Park,VT: Antimicrobial Therapy, Inc.; 2000.

Gold HS, Moellering RC. Antimicrobial-drug resistance. N Engl J Med. 1996;335:1445-1453.

Gonzales R, Sande M: What will it take to stop physicians from prescribing antibiotics in acute bronchitis? Lancet 1995 Mar 18; 345(8951): 665-6

Hooton TM, Stamm WE. Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin North Am 1997;11:551-581.

Lipsky BA, Berendt AR.Principles and practice of antibiotic therapy of diabetic foot infections.
Diabetes Metab Res Rev. 2000 Sep-Oct;16 Suppl 1:S42-6.

Mufson MA.Pneumococcal Pneumonia.
Curr Infect Dis Rep. 1999 Apr;1(1):57-64.

Reese RE, Betts RF: A Practical Approach to Infectious Diseases. 4th ed. Boston: Little, Brown, and Company; 1996: 251

Stefani SD, Cadore LP, Villaroel RU, Azevedo S, Machado AL. Antibiotic Selection in the Treatment of Febrile Neutropenia: Current Approach and New Directions.
Braz J Infect Dis. 1998 Jun;2(3):109-117.

Stamm WE, Hooton TM. Management of urinary tract infections in adults. N Engl J Med 1993;329:1328-1334.