Joesoef MR, Schmid GP, Hillier SL. Bacterial vaginosis: review of treatment options and potential clinical implications for therapy. Clin Infect Dis 1999;28(suppl 1):S57-S65. Pooled data from five RCTs found no significant difference between cucmulative cure rates 5-10 days after finishing treatment for metronidazole 400 mg BD for 7 days (86%), intravaginal metronidazole 5g BD for 5 days (81%) or intravaginal clindamycin 5g at night for 7 days (85%).

McDonald HM, Brocklehurst P, Gordon A. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database of Systematic Reviews 2007, Issue 1. http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000262/frame.html
Accessed 23.09.14. RATIONALE: Pooled data from 10 RCTs indicated that both oral and intravaginal antibiotics are effective at eradicating bacterial vaginosis in pregnant women. Oral antibiotics compared with placebo (seven trials, n = 3244) OR 0.15, 95% CI 0.13 to 0.17. Intravaginal antibiotics compared with placebo (three trials, n = 1113) OR 0.27, 95% CI 0.21 to 0.35.

Joesoef MR, Schmid GP. Bacterial vaginosis: review of treatment options and potential clinical implications for therapy. Clin Infect Dis 1995;20(Suppl 1):S72-S79. RATIONALE: The 2g single dose is less effective than the 7-day course at 4-week follow up. When data from studies that only directly compared the two dose regimens were pooled, the cumulative cure rates 3-4 weeks after completion of treatment were 62% for the single-dose regimen and 82% for the 7-day regimen (p < 0.005).

UKTIS. Use of metronidazole in pregnancy. The UK Teratology Information Service. 2008. (Tel: 0844 892 0909, www.toxbase.org) Accessed 23.09.14.. RATIONALE: The available data (almost exclusively based on oral treatment) does not indicate an increased risk of adverse fetal effects associated with metronidazole use during pregnancy. The manufacturer advises
avoidance of the 2g stat regimen during pregnancy.

BASHH. National guideline for the management of bacterial vaginosis. British Association for Sexual Health and HIV. 2006. http://www.bashh.org/documents/62/62.pdf Accessed 23.09.14. RATIONALE: No reduction in relapse rate was reported from two studies in which male partners of women with BV were treated with metronidazole, tinidazole, or clindamycin.

The POCAST project is funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London and by the Imperial College Healthcare Charity (Grant Ref No:7006/P36U).