What would the management be for a patient diagnosed with bacterial vaginosis presenting with fishy vaginal discharge?

The management of bacterial vaginosis (BV) primarily involves antibiotic treatment aimed at restoring the natural balance of bacteria in the vagina. Metronidazole is the first-line treatment for bacterial vaginosis and can be administered either orally or vaginally. This antibiotic works effectively against the anaerobic bacteria overgrowth that characterizes BV, helping to alleviate symptoms such as the fishy vaginal discharge.

Using metronidazole either orally or vaginally allows for flexibility depending on patient preference and tolerance. The oral route may be preferred for individuals who are comfortable with taking medication by mouth, whereas the vaginal application may benefit those who experience gastrointestinal side effects from systemic medications.

Choosing this option is supported by clinical guidelines that recommend metronidazole as a standard treatment for bacterial vaginosis. In contrast, other antibiotics listed, while useful in treating other infections, are not the recommended first-line therapy specifically for BV.