How to treat bacterial vaginitis

Vaginitis is a disease that is difficult to treat. During an attack, patients will feel very painful and often experience itching inside their vagina. This itching is quite unbearable. Most patients need to use anaerobic drugs, such as metronidazole and clindamycin. These drugs can effectively treat their vaginitis problems.

Generally, the drug treatment for vaginitis is mainly external use. Patients with pelvic inflammatory disease or recurrent vaginitis can take oral medications. If necessary, couples can be treated together. Note that long-term oral antibiotics may inhibit normal flora and cause secondary fungal infection.

1. Bacterial vaginosis

The principle of treatment is to use anti-anaerobic drugs, mainly metronidazole, tinidazole, and clindamycin. Caution: Disulfiram-like reactions may occur with both oral and topical metronidazole.

(1) Oral medication: Metronidazole is the first choice.

(2) Local drug treatment.

(3) Sexual partners do not require routine treatment.

2. Candidal vaginitis

(1) Eliminate the cause: If you have diabetes, you should be treated actively and stop using broad-spectrum antibiotics, estrogen and cortisol in time. Change your underwear frequently, and wash used underwear, basins, and towels with boiling water.

(2) Topical medications: miconazole suppositories, clotrimazole suppositories, and nystatin suppositories.

(3) Systemic medications (for patients with recurrent attacks or who cannot take vaginal medication): fluconazole, itraconazole, and ketoconazole. Fluconazole has a lower risk of hepatotoxicity and should be used instead of ketoconazole.

(4) Sexual partners should be tested and treated for Candida albicans.

(5) Pregnancy complicated by Candida vaginitis is mainly treated with local treatment, and oral azole drugs are contraindicated.

3. Trichomonas vaginitis

(1) Local vaginal medication: Metronidazole vaginal effervescent tablets or 0.75% metronidazole gel, 1% lactic acid or 0.5% acetic acid solution flushing can relieve symptoms.

(2) Systemic medication: Metronidazole can be used for initial treatment, but the medication should be discontinued if side effects are detected. Do not drink alcohol during the use of metronidazole and within 24 hours of stopping the medication, and do not drink alcohol during the use of tinidazole and within 72 hours of stopping the medication. The efficacy and side effects of metronidazole and tinidazole are similar, including possible disulfiram-like reactions. Do not breastfeed while taking medication.

(3) Sexual partners should receive treatment at the same time and avoid unprotected sexual intercourse before recovery.