Warning
  • Testing for bacterial vaginosis is with charcoal vaginal swab. Testing should be performed prior to treatment, especially if symptoms are persistent or recurrent.
  • Full STI screening is recommended, to include chlamydia, gonorrhoea, HIV and syphilis.
  • For problematic recurrent BV, refer to sexual health.
  • Oral metronidazole is cheaper and as effective as topical. 
  • Provide general washing advice and smoking cessation.
  • Patient information is available here.

Drug details

Oral Metronidazole 400mg twice daily

5 to 7 days

OR Metronidazole 0·75% vaginal gel 5g applicatorful at night

5 nights

OR Clindamycin 2% vaginal cream 5g applicatorful at night

7 nights

Editorial Information

Last reviewed: 27/02/2023

Next review date: 27/02/2026

Author(s): Antimicrobial Management Team.

Approved By: TAM Subgroup of ADTC

Reviewer name(s): Alison Macdonald, Area Antimicrobial Pharmacist.

Document Id: AMT123