A lady presented with creamy white vaginal discharge with fishy odor, drug of choice is:
Doxycycline
Ofloxacine
Metronidazole
Clindamycin
Ans. is c, i.e. MetronidazoleRef: Shaw 15th/ed, p131; CGDT 10th/ed, p670; William's Gynae 1st/ed, p51Creamy white discharge with fishy odor is characteristic of bacterial vaginosis (M/C cause Gardnerella)Drug of choice for management of bacterial vaginosis/Gardnerella vaginitis is --Metronidazole:Dose - 500mg oral metronidazole is given twice daily for 7 daysAlternatively, metronidazole gel (can be applied once daily for 5 days or clindamycin cream (2%) at bedtime for 5 days.Note: Treatment of male sexual partner is not required in bacterial vaginosisQ.In pregnancy:* Bacterial vaginosis is associated with preterm birth and premature rupture of membranes.* Treatment is reserved for symptomatic women who usually complain of fishy odor.* DOC - Metronidazole (oral) in the 2nd and the 3rd trimester.Unfortunately, treatment does not reduce preterm birth and routine screening is not recommended.
Sexually Transmitted Disease in the Female