Guidelines for the treatment of bacterial vaginosis: focus on tinidazole

Laura J Dickey¹, Michael D Nailor^2,3, Jack D Sobel⁴

¹Department of Pharmacy Services, Detroit Receiving Hospital, Detroit, MI, USA; ²University of Connecticut, School of Pharmacy, Storrs, CT, USA; ³Hartford Hospital, Department of Pharmacy, Hartford, CT, USA; ⁴Wayne State University, School of Medicine, Detroit, MI, USA

Abstract: Bacterial vaginosis (BV) is a complex vaginal infection most commonly associated with women of child-bearing age. Risk factors for BV are numerous. There are currently multiple clinical and laboratory tests for diagnosis of BV, including the most commonly used diagnostic methods: Amsel’s criteria or Nugent’s Gram stain scale. The mainstay of BV therapy is metronidazole, but tinidazole as well as a few other agents have also been used successfully. Tinidazole is the second nitroimidazole antiprotozoal agent and a structural derivative of metronidazole. With a favorable pharmacokinetic profile and reduced side effects, tinidazole is an alternative agent for BV treatment. There are minimal head-to-head comparative data to establish tinidazole’s superiority to metronidazole or other therapeutic agents. Available data suggest tinidazole has a role in special populations particularly for refractory or relapsing BV.

Keywords: bacterial vaginosis, vaginosis, tinidazole, Gardnerella