Why Antibiotics Almost Always Don’t Cure Bacterial Vaginosis

The Centers for Disease Control (CDC) recommends three possible antibiotic treatments for bacterial vaginosis.

  1. 500 mg metronidazole (Flagyl) given orally twice daily for 7 days
  2. Metronidazole (Flagyl) gel vaginally once daily for 5 days
  3. Clindamycin cream applied vaginally at bedtime for 7 days

These CDC treatments are used by general medicine, obstetrics and gynecology and internal medicine practitioners.

How Antibiotic Works

Antibiotics kill bacteria and other microbes in the body and stop them from multiplying each time a dosage is taken. The problem is that antibiotics are not selective. The body has natural flora that is found in the inside of the mouth, in the GI tract lining, inside the lungs, vagina, rectum, and within each organ. When an antibiotic is taken, the natural flora in all linings of the organs are affected, not just the natural flora of the vagina.

Thus, when a woman with bacterial vaginosis uses an antibiotic, there is a temporary reduction in the number of anaerobic bacteria in the vagina that are related to the illness. Some relief is felt; however, within a few weeks, the vaginosis symptoms return, often worse than they were before the drug was used. The bacterial vaginosis then becomes recurring.

The problem is that the antibiotic killed off the healthy flora as well as the anaerobic bacteria and healthy flora must be replaced if health is to return. Antibiotics don’t replace the healthy flora.

Side Effects of Clindamycin

Clindamycin side effects include the following –  fungal infection, genital itching and/or burning, severe allergic reactions including swelling of the mouth, face, lips and tongue and chest tightness along with difficulty breathing), diarrhea, blood or mucus in the stools, white vaginal discharge, and itching that worsens. A rash or hives can also be included among the severe allergic reactions.

Side Effects of Flagyl

Metronidazole (Flagyl) given in an oral dose form twice daily is the most effective antibiotic for bacterial vaginosis but still has a recurrence rate of 20%. When it was given once daily in the research studies, relapse rates rose to between 35 to 50% one month later. The vaginal creams initially had cure rates of 50-95% but relapse rates were 34 to 49% four weeks later.

The concern about these statistics is that researchers cannot differentiate treatment failure from recurrence because women often show no actual symptoms of the disease.

When you have bacterial vaginosis, it’s important to keep searching for a permanent solution to the problem.

Antibiotics are clearly not the answer.