What is the prescription for clindamycin (antibiotic) for a male whose wife has been diagnosed with bacterial vaginosis?

From the Guidelines

I cannot write a prescription for clindamycin for a male whose wife has bacterial vaginosis. Bacterial vaginosis (BV) is a condition that affects the vaginal microbiome and only occurs in individuals with vaginas. While BV can sometimes be associated with sexual activity, it is not considered a sexually transmitted infection that requires treatment of male partners. Current medical guidelines do not recommend treating male partners of women with BV, as studies have not shown that partner treatment reduces recurrence rates in women 1, 2.

Key Points to Consider

• The principal goal of therapy for BV is to relieve vaginal symptoms and signs in women, and only women with symptomatic disease require treatment 2.
• Treatment of male partners has not been shown to alter either the clinical course of BV in women during treatment or the relapse/reinfection rate 2.
• If you are concerned about potentially contributing to your wife's condition, the best approach would be to practice good hygiene and consider using condoms during sexual activity while she completes her treatment.
• If you're experiencing symptoms yourself, you should consult with your own healthcare provider for proper evaluation and appropriate treatment based on your specific symptoms and condition.

Relevant Treatment Guidelines

According to the guideline on antimicrobial therapy of sexually transmitted diseases 3, the recommended treatment for bacterial vaginosis in women includes metronidazole or clindamycin, but it does not recommend treatment for male partners.

From the Research

Treatment of Bacterial Vaginosis in Male Partners

To write a prescription for clindamycin for a male partner of a woman diagnosed with bacterial vaginosis, consider the following:

• The male partner can be treated with oral metronidazole and 2% clindamycin cream applied topically to penile skin, both twice daily for 7 days 4, 5
• This treatment regimen has been shown to reduce the abundance of BV-associated bacteria and alter the overall microbiota composition of the genital sites 4
• The use of clindamycin in male partners may help prevent recurrence of bacterial vaginosis in their female partners 5

Dosage and Administration

• The dosage of clindamycin for male partners is not explicitly stated in the provided studies, but it can be inferred that 2% clindamycin cream applied topically to penile skin, twice daily for 7 days, may be an effective treatment regimen 4, 5
• Oral clindamycin can be used as an alternative treatment option, but the dosage and duration of treatment are not specified in the provided studies

Efficacy and Safety

• The efficacy of clindamycin in treating bacterial vaginosis in male partners has been demonstrated in several studies 4, 5
• The safety of clindamycin in male partners has also been evaluated, with adverse events including nausea, headache, and metallic taste 5
• The use of clindamycin in male partners may be associated with a lower rate of recurrence of bacterial vaginosis in their female partners 5

Alternative Treatment Options

• Other treatment options for bacterial vaginosis in male partners may include oral metronidazole, alone or in combination with topical antimicrobial therapy 4, 5
• The choice of treatment regimen should be based on the individual patient's needs and medical history, as well as the severity of the infection 6, 7, 8