Which treatment is first line for Bacterial Vaginosis?

Bacterial vaginosis (BV) is a common condition caused by an imbalance in the normal bacteria found in the vagina. The treatment of choice for this condition is metronidazole, which is an antibiotic effective against the pathogens involved in BV.

Metronidazole works by disrupting the DNA of anaerobic bacteria and protozoa, leading to bacterial cell death. It is available in both oral and topical formulations, but the oral form is commonly used due to its systemic efficacy. Metronidazole's effectiveness and low side effect profile make it the preferred first-line treatment for bacterial vaginosis.

Other options, while they may have roles in treating different infections, are not typically recommended as first-line treatments for BV. For example, ceftriaxone is primarily used to treat gonococcal infections, azithromycin is more commonly used for chlamydia and some other infections, and clindamycin cream may be used in cases of BV but is not the first-line option compared to metronidazole. Because of the specific bacteria involved in BV and the proven effectiveness of metronidazole, it remains the preferred choice in clinical practice.