Miconazole 2 percent cream (Monistat 7), 5 g per day intravaginally for 7 days * † Metronidazole, 2 g orally once daily for 3 to 5 days (Note that treatment of sexual partners increases cure rate.)īutoconazole 2 percent cream (Femstat 3, Mycelex-3), 5 g per day intravaginally for 3 days * †Ĭlotrimazole 1 percent cream (Mycelex-7), 5 g per day intravaginally for 7 to 14 days * †Ĭlotrimazole 100-mg vaginal tablet (Gyne-Lotrimen, Mycelex), one tablet per day intravaginally for 7 days *Ĭlotrimazole 100-mg vaginal tablet, two tablets per day intravaginally for 3 days *Ĭlotrimazole 500-mg vaginal tablet (Mycelex-G), one tablet intravaginally in a single application *
#Gram negative rods blood culture full
Metronidazole gel 0.75 percent, one full applicator (5 g) intravaginally twice daily for 5 days (acceptable only in women who have not had a previous premature delivery)įor four or more episodes of symptomatic vulvovaginal candidiasis annually: initial acute intravaginal regimen for 10 to 14 days followed immediately by maintenance regimen for at least 6 months (e.g., ketoconazole, 100 mg orally once daily) Metronidazole, 2 g orally in a single dose ∥ Clindamycin, 300 mg orally twice daily for 7 days ∥ Metronidazole, 2 g orally in a single dose (usually not recommended in first trimester) Only topical azole agents intravaginally for 7 to 10 days Metronidazole, 250 mg orally three times daily for 7 days (recommended regimen) ∥ Metronidazole, 500 mg orally twice daily for 7 days Metronidazole, 2 g orally in a single dose Clindamycin (Cleocin), 300 mg orally twice daily for 7 daysīoric acid powder in size-0 gelatin capsules intravaginally once or twice daily for 2 weeks § Metronidazole gel 0.75 percent (Metrogel-Vaginal), one full applicator (5 g) intravaginally twice daily for 5 days * Metronidazole, 2 g orally in a single dose ‡Ĭlindamycin phosphate vaginal cream 2 percent (Cleocin Vaginal), one full applicator (5 g) intravaginally each night for 7 days * (Note that oil-based cream may weaken condoms and diaphragms.) Topical antifungal agents † (see Table 6) Fluconazole (Diflucan), 150 mg orally one time Metronidazole (Flagyl), 500 mg orally twice daily for seven days * Motile trichomonads Many polymorphonuclear cellsĪmsel's criteria (three of four criteria must be met): provides correct diagnosis in 90 percent of affected womenĭNA probe tests: sensitivity of 90 percent and specificity of 99.8 percentĬulture: sensitivity of 98 percent and specificity of 100 percentĬriteria of Nugent or Spiegel for Gram stain to diagnose bacterial vaginosis Other tests are controversial. Pseudohyphae, mycelial tangles or budding yeast cells “Clue cells” (vaginal epithelial cells coated with coccobacilli) Few lactobacilli Occasional motile, curved rods (Mobiluncus species) Microscopic examination of wet-mount and KOH preparations of vaginal discharge Vulvar and vaginal edema and erythema “Strawberry” cervix in up to 25 percent of affected women Frothy, purulent discharge Vulvar and vaginal erythema, edema and fissures Thick, white discharge that adheres to vaginal walls Usually, normal appearance of tissue discolored discharge with abnormal odor, homogeneous discharge that adheres to vaginal walls Thick, white (“cottage cheese”) discharge with no odor Pruritus DysuriaĬopious, malodorous, yellow- green (or discolored) discharge Pruritus Vaginal irritation No symptoms in 20 to 50 percent of affected women Thin, off-white discharge Unpleasant “fishy” odor, with odor increasing after sexual intercourse
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