Clindamycin Vaginal Cream for Bacterial Vaginosis
Yes, clindamycin vaginal cream (2%) is available as a treatment option for bacterial vaginosis, and is recommended by CDC guidelines as an effective alternative to metronidazole. 1
Treatment Options for Bacterial Vaginosis
Clindamycin vaginal cream is one of several FDA-approved treatments for bacterial vaginosis:
- Clindamycin cream 2%: One full applicator (5g) intravaginally at bedtime for 7 days 2, 1
- Metronidazole 500mg orally twice daily for 7 days
- Metronidazole gel 0.75%, one full applicator (5g) intravaginally once daily for 5 days
Efficacy of Clindamycin Vaginal Cream
Clinical trials have demonstrated that clindamycin vaginal cream has comparable efficacy to oral metronidazole:
- Randomized controlled trials show cure rates of 86-97% for clindamycin vaginal cream 3, 4
- The 2% concentration of clindamycin cream has been shown to be most effective, resulting in clinical resolution of BV in 94% of women in one study 5
- Patients using intravaginal products like clindamycin cream reported higher satisfaction with treatment compared to oral options 6
Advantages of Clindamycin Vaginal Cream
- Lower systemic absorption: Mean bioavailability of clindamycin cream is approximately 4%, reducing systemic side effects 2, 1
- Alternative for metronidazole allergy: Clindamycin cream is the preferred treatment for patients with allergy or intolerance to metronidazole 2, 1
- First-trimester pregnancy option: Clindamycin vaginal cream is the preferred treatment for BV during the first trimester of pregnancy when metronidazole is contraindicated 2, 1
Important Considerations
- Clindamycin cream is oil-based and may weaken latex condoms and diaphragms 1
- No follow-up visits are necessary if symptoms resolve 2, 1
- Recurrence of BV is common, and patients should be advised to return for additional therapy if symptoms recur 1
- Treatment of sex partners has not been shown to influence treatment response or recurrence rates, so routine treatment of partners is not recommended 2, 1
Special Populations
Pregnancy
- Clindamycin vaginal cream is preferred during the first trimester of pregnancy 2
- However, some evidence suggests potential adverse events with clindamycin cream use during pregnancy, particularly in later trimesters 2, 1
Alternative Formulations
- Clindamycin ovules (100g intravaginally once at bedtime for 3 days) are also available as an alternative to cream with similar efficacy 2, 7
Clindamycin vaginal cream represents an effective treatment option for bacterial vaginosis with particular advantages for patients with metronidazole allergies or those in early pregnancy.