Bacterial Vaginosis Treatment Should Preserve Good Bacteria While Eliminating The Bad

Bacterial vaginosis is a condition of imbalance of bacteria that are healthy and bacteria that cause discharge, odor and irritation. Often the gynos have termed these the "good and the bad" bacteria.  BV is typically mild, but can be very uncomfortable, and most gynos do recommend you treat these infection, although they can be self limiting over a period of a few days. The odor is usually described as fishy, and it gets stronger after sex. The discharge is grey, or off-white in color, and typically runny. The bacteria that cause the condition of BV will typically reside in the vagina when there are no symptoms, so if not treated, recurrence of infection is common. New sex partners are the typical cause, but treatment with antibiotics, nutrition, smoking, douching may be the cause. In other women, there really is no specific determined cause. Culture tests can determine organisms that are causing the symptoms, but most women will not need culture tests. Because the presence of the good and healthy bacteria is a must for long term vaginal health, it is important to select a treatment that preserves the good bacteria. This is why the medication metronidazole is such an excellent choice. It will not kill the lactobacilli which are the good bacteria, but it has potent activity against most of the organisms in the vagina. About 85% of women will be cured of their infection if treated, so follow up with your gyno is important to make sure the infection is resolved after treatment.  is a mild infection of the vagina caused by bacteria. Normally, there are a lot of "good" bacteria and some "bad" bacteria in the vagina. The good types help control the growth of the bad types. In women with bacterial vaginosis, the balance is upset. There are not enough good bacteria and too many bad bacteria.


  1. How effective is Microbid for VB? Does it kill the good ones too?

  2. Macrobid or nitrofurantoin is primarily excreted in urine and thus works well for UTIs. Because of its local level in urine it is less likely to affect bacteria in the vagina. Thus it's not a good treatment for BV.

  3. Thanks for your reply.


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