For most women, bacterial vaginosis is simply a nuisance, and the goal of treatment is to relieve symptoms. Doctors commonly treat bacterial vaginosis with metronidazole (Flagyl or MetroGel-Vaginal) or clindamycin (Cleocin). Either can be taken by mouth or applied as a vaginal cream or gel. However, the U.S. Centers for Disease Control and Prevention (CDC) recommends that all pregnant women with symptoms be treated with oral medications because the medications are safe and work better than vaginal creams or gels. Studies show that a seven-day treatment with oral metronidazole or a five-day treatment with metronidazole vaginal gel is equally effective in non-pregnant women. Clindamycin vaginal cream is slightly less effective than either type of metronidazole.
All women with symptoms of bacterial vaginosis should be treated. Some women also should be screened for bacterial vaginosis even if they don't have symptoms. Pregnant women who are at high risk of preterm labor and delivery should be tested for bacterial vaginosis and considered for treatment if it is detected. Some physicians also recommend that women undergoing certain gynecological procedures be tested for bacterial vaginosis, and treated even if symptoms are not present. This is because bacterial vaginosis has been associated with the development of pelvic inflammatory disease and other infections after endometrial biopsy, surgical abortion, hysterectomy, intrauterine device placement, Caesarean section and uterine curettage.
Doctors do not recommend routine treatment for the male sex partners of women who have bacterial vaginosis.