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Antimicrobial prescribing: NHS Lothian
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Genital infections in pregnancy and breast feeding
Bacterial vaginosis in pregnancy or breast feeding

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Bacterial vaginosis in pregnancy or breast feeding

Antimicrobial prescribing: NHS Lothian

NHS Lothian

If discharge is thin/watery, white/grey and offensive/fishy with no discomfort or itch, and pH >4 likely diagnosis is bacterial vaginosis.

Antibiotic Recommendation

Metronidazole 400mg every 12 hours orally for 7 days

Metronidazole (0.75%) gel 5g at night intravaginally for 5 days

Clindamycin (2%) cream 5g at night intravaginally for 7 days

Notes

Expect to see Clue cells reported in HVS.
Screening or treatment of partners is not required.
Clindamycin cream can weaken condoms.
There is insufficient evidence to recommend routine treatment of asymptomatic pregnant women who attend a GU clinic and are found to have BV. Women with additional risk factors for preterm birth may benefit from treatment before 20 week gestation.
For lactating women topical treatment preferred, as metronidazole may affect taste of breast milk.