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Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: OB GYN
Satisfied Customers: 3111
Experience:  MBBS, MD, MCCM.Currently working in Critical Care Medicine with 10 year experience in Medicine
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I was diagnosed with BV and a yeast infection two weeks ago.

Customer Question

I was diagnosed with BV and a yeast infection two weeks ago. I took metronidazole for 7 days. I didn't seem to be any better and actually felt very itchy, so I went to my OBGYN who swabbed me and said I was positive for BV and yeast. So the BV was not cured with the 7 day oral metronidazole. I had just started spotting (from a new birth control), so my OB said to wait a couple of days and start a 7 day treatment of clindamycin phosphate vaginal cream. He also prescribed a single dose of diflucan to take the day the treatment was over, as to make sure the yeast infection didn't come back. The soreness and itching is gone, but the fishy odor and watery discharge is still there. I am two days out of the second BV treatment. How long should it take for the odor and discharge symptoms to fully clear up. My OB said it could take another week, but that seems incredibly long. What should I look for to determine if I need to head back in to see him, should the infection not be fully cured again? Also, is this a normal occurrence- to have a stubborn BV?
Submitted: 5 months ago.
Category: OB GYN
Expert:  Dr. Muneeb Ali replied 5 months ago.

Hi,

Im sorry to hear about your symptoms. Well BV can be a difficult infection to treat in some cases. Infact it has been estimated that upto 30% of patients can relapse within the first three months of completion of therapy. Now your doctor has certainly prescribed you the right therapy for this problem. Metronidazole followed by clindamycin in the right therapy. And it can take upto a week after the completion of therapy for the fish like odor to disappear. It can even take upto 10 days for the odor to completely resolve. Now if the symptoms dont improve then tinidazole can be used which is a newer form of therapy and would be effective if the other two fail.

Now what you need to be looking for in case of a relapse are worsening of the discharge and the smell and if they get worse or dont seem to resolve by the end of the week then you would need to be treated again. Sometimes topical boric acid has been used with some efficacy in case of resistant infections. In some cases combination therapy can be instituted to improve the outcomes as well.

Now to simply answer your questions,

1) yes it is common for patients to have difficult to treat BV

2) Look for worsening of your symptoms to indicate that the treatment hasnt worked or you have relapsed after the week is up.

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