Patient's question:
Detailed medical condition and consultation purpose:My clue cells are positive. I have undergone two courses of treatment without improvement. The first time the doctor prescribed (on November 1): tablets of Tioxazole, OFX suppositories, and Ganlin rinse; the second time (on November 24): tablets of Tioxazole, Metronidazole suppositories, and Jieryin rinse. I have finished all the medication, just finished taking it, and haven’t gone for a follow-up yet. However, sometimes I still feel a bit itchy, so I think it hasn’t fully recovered.
During the treatment, I did not have sexual intercourse with my husband. When I first went for the check-up, I also had tests for mycoplasma and E. coli.
Doctor's answer:
Bacterial vaginosis (BV), also known as bacterial vaginitis, nonspecific vaginitis, Gardnerella vaginitis, or Haemophilus vaginitis, is a syndrome characterized by the absence of vaginal mucosal inflammation, caused by the imbalance of the vaginal microecological system, the significant reduction or disappearance of the dominant facultative anaerobic bacteria—Lactobacillus, and the excessive growth of opportunistic pathogens such as Gardnerella, Campylobacter, Bacteroides, and Prevotella. Its main symptoms include increased vaginal discharge with an odor and discomfort in the external genitalia, with approximately 50% of patients being asymptomatic.Asymptomatic patients typically do not require treatment unless they are pregnant or have excessive discharge. Symptomatic patients need treatment regardless of pregnancy status. Before undergoing an induced abortion, treatment should be considered for both symptomatic and asymptomatic patients. The first-line drug for treating bacterial vaginosis is metronidazole (Flagyl). The treatment regimen is as follows:
1. Systemic Medication:
▲ Metronidazole, 500 mg orally twice daily for 7 days. Some recommend three consecutive courses for the best efficacy.
▲ Metronidazole, 2.0 g orally once (this method has 10% lower efficacy compared to the 7-day regimen).
▲ Clindamycin, 300 mg orally twice daily for 7 days, with an efficacy rate of 94%.
2. Local Medication:
▲ 0.75% metronidazole suppositories, inserted into the vagina twice daily for 5 days.