R.S. is a 32-year old woman diagnosed with bacterial vaginosis. The goal is to rid the patient of vaginal discharge and odor. Antibiotics would be the treatment option for this disease and one of the antibiotics would be Metronidazole. This option is appropriate because of its quality penetration quality allowing to go into tissues and treat infections caused by anaerobic bacteria in the genitourinary parts of the body. In addition, a study by InformedHealth.org explains that 90% of women undergoing medication using Metronidazole show no signs of the disease after treatment (2018). The patient should consume 500 mg tablets twice in a day for seven days. In addition, the patient should not stop taking the medication before completing the dose because it would make the body develop a resistant strain.
This medication could potentially cause nausea, or constipation. Alternatively, the patient can explore over the counter medications such as Clindamycin and Tinidazole because they are safe and effective in treating the condition. One of the dietary recommendations for this patient is probiotics. Probiotics are live and beneficial bacteria found in food and other supplements, that can restore the balance in vaginal bacteria (Tuddenham et al., 2019). Some probiotic foods include yoghurt, kimchi and pickles. She can also eat prebiotic compounds, which are vital towards stabilizing vaginal Ph by enhancing the development of beneficial bacteria. Foods containing prebiotic compounds include bananas, soybeans and oats. Additionally, the patient should maintain body hygiene and avoid wearing tight clothing.
Tuddenham, S., Ghanem, K. G., Caulfield, L. E., Rovner, A. J., Robinson, C., Shivakoti, R., … & Brotman, R. M. (2019). Associations between dietary micronutrient intake and molecular-Bacterial Vaginosis. Reproductive health, 16(1), 1-8.
InformedHealth.org [Internet] (2018). Cologne, Germany: Institute for Quality and Efficiency in Health Care. Which treatments are effective for bacterial vaginosis? Available from: https://www.ncbi.nlm.nih.gov/books/NBK298830/
Damian Vega Torres
Discussion week 12
Bacterial vaginosis (BV) is a common vaginal infection. Jones (2019) attributes it to vaginal flora alterations resulting from bacterial overgrowth in vagina. According to Girerd (2021), it is mainly characterized by unpleasant odor and mild to moderate increased vaginal discharge. R.S.’s condition is manageable through appropriate drug therapy and behavioral modifications.
R.S.’s condition is manageable through appropriate drug therapy and behavioral modifications. Therefore, the main treatment goals are to administer recommended antibiotics and educate the patient about the risk factors for the disease. The overall aim is to cure the condition and prevent its recurrence.
Antibiotics are the mainstay of therapy for BV. Jones (2019) and Paladine and Desai (2018) recommend 500mg of oral metronidazole (Flagyl) as the standard drug therapy for BV management. The tablet should be taken twice daily for seven days (Jones, 2019; Paladine & Desai, 2018). Jones (2019) notes that it is effective for BV treatment according to the 2015 Centers for Disease Control and Prevention’s (CDC’s) Sexually Transmitted Disease (STD) treatment guidelines. Thus, metronidazole is the standard drug therapy for BV treatment.
R.S.’s condition may be attributed to her biweekly habit of using a commercial douche. According to Girerd (2021), she must stop this practice to avoid BV recurrence. Additionally, it is expected that the disease will resolve once R.S. completes the recommended dosage. However, she may take a second dose of the same drug or switch to another agent, such as clindamycin, if it persists (Girerd, 2021). The patient should also be informed about the risks associated with its use. For example, Girerd (2021) indicates that it may alter the vaginal flora and lead to vaginal candidiasis development. In general, she should be educated about the disease’s basic pathophysiology, natural history, and risk factors (Girerd, 2021). This knowledge will promote positive behavioral change and strict adherence to the prescribed treatment regimen.
Metronidazole causes various side effects. According to the University of Illinois-Chicago (2018), it may lead to loss of appetite, headache, nausea, diarrhea, heartburn, and cramping of the stomach area. These effects are mild and tend to disappear in a few days or weeks. However, patients should seek immediate medical intervention if they experience severe adverse reactions encompassing nervous system effects, such as seizures and encephalopathy. Thus, R.S. must be on the lookout for symptoms such as convulsions, dizziness, confusion, and ataxia (University of Illinois-Chicago, 2018). These reactions are the common side effects associated with metronidazole use.
BV can be managed using various antibiotics. According to the 2015 CDC’s STD treatment guidelines, it can be treated using metronidazole, 0.75% topical gel, and clindamycin cream, 2% administered vaginally at bedtime (Jones, 2019). Jones (2019) indicates that the former should be applied for five days while the latter for a week. Alternatively, patients may use tinidazole, 2g daily for two days or 1g for five days, or Clindamycin, 300mg twice daily for a week (Jones, 2019). These regimens are equally efficacious as 500mg of oral metronidazole.
Behavioral modification minimizes risks for BV development and recurrence. R.S. should stop douching, bubble bathing, or using other over-the-counter vaginal hygiene products (Girerd, 2021). Additionally, Girerd (2021) suggests that she should avoid liquid soaps and body washes. These practices increase the risk for BV development and recurrence.
R.S.’s condition is manageable through appropriate drug therapy and behavioral modifications. BV can be cured using 500mg of oral metronidazole taken twice daily for seven days or metronidazole 0.75% topical gel administered vaginally at bedtime for five days. Patients are also required to stop using over-the-counter vaginal hygiene products to reduce the risk of BV development and recurrence. In general, people are advised to seek immediate medical intervention if they notice an unpleasant vaginal odor and a mild to moderate increase in vaginal discharge.
Girerd, P. H. (2021). Bacterial vaginosis. Retrieved from https://emedicine.medscape.com/article/254342-overview#a4
Jones, A. (2019). Bacterial vaginosis: A review of treatment, recurrence, and disparities. The Journal for Nurse Practitioners, 15(6), 420-423. https://doi.org/10.1016/j.nurpra.2019.03.010
Paladine, H. L., & Desai, U. A. (2018). Vaginitis: Diagnosis and treatment. American Family Physician, 97(5), 321-329. https://www.aafp.org/afp/2018/0301/afp20180301p321.pdf
University of Illinois-Chicago. (2018). Metronidazole, oral tablet. Retrieved from https://www.medicalnewstoday.com/articles/metronidazole-oral-tablet#Highlights-for-metronidazole
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