From the Guidelines
Prevotella bivia infections are typically treated with antibiotics that are effective against anaerobic bacteria, with metronidazole 500 mg orally three times daily for 7-14 days being a common first-line treatment 1. The choice of antibiotic depends on the severity and location of the infection, as well as the presence of any underlying medical conditions.
- Metronidazole is a commonly used antibiotic for treating P. bivia infections, especially in the female genital tract 1.
- Clindamycin 300-450 mg orally four times daily for 7-14 days can be used as an alternative, especially if the infection is in the female genital tract where P. bivia is commonly found 1.
- For more severe infections, intravenous therapy may be necessary, such as metronidazole 500 mg IV every 8 hours or clindamycin 600-900 mg IV every 8 hours until clinical improvement, followed by oral therapy to complete the course 1.
- Amoxicillin-clavulanate (875/125 mg twice daily) can be an effective option for treating P. bivia infections, especially if the strain produces beta-lactamases, as it contains a beta-lactamase inhibitor 1. It's essential to complete the full course of antibiotics even if symptoms improve before completion to prevent recurrence and antibiotic resistance. P. bivia is an anaerobic gram-negative bacterium that commonly resides in the vagina, mouth, and intestinal tract, and infections often occur when this normal flora enters sterile sites or becomes overgrown, disrupting the microbial balance. The treatment of P. bivia infections should be guided by the most recent and highest quality evidence, which recommends the use of antibiotics that are effective against anaerobic bacteria, such as metronidazole or clindamycin 1.
From the FDA Drug Label
Anaerobic Bacterial Infections Metronidazole tablets are indicated in the treatment of serious infections caused by susceptible anaerobic bacteria INTRA‑ABDOMINAL INFECTIONS, including peritonitis, intra‑abdominal abscess, and liver abscess, caused by Bacteroides species including the B. fragilis group (B. fragilis, B. distasonis, B. ovatus, B. thetaiotaomicron, B vulgatus), Clostridium species, Eubacterium species, Peptococcusniger, and Peptostreptococcus species.
The usual adult oral dosage is 7. 5 mg/kg every six hours (approx. 500 mg for a 70 kg adult). A maximum of 4 g should not be exceeded during a 24 hour period. The usual duration of therapy is 7 to 10 days; however, infections of the bone and joint, lower respiratory tract, and endocardium may require longer treatment
The treatment for Provotella bivia, an anaerobic bacteria, is metronidazole. The recommended dosage is 7.5 mg/kg every six hours, with a maximum of 4 g per day. The usual duration of therapy is 7 to 10 days 2.
From the Research
Treatment of Prevotella bivia
To treat Prevotella bivia, several antibiotics can be considered based on their susceptibility patterns. The following points summarize the key findings:
- Antibiotic susceptibility: Studies have shown that Prevotella bivia is susceptible to certain antibiotics, including:
- Resistance patterns: However, resistance to some antibiotics has been reported, including:
- Treatment considerations: Based on these findings, treatment of Prevotella bivia infections should be guided by antimicrobial susceptibility testing to ensure effective therapy 4, 5. In cases where susceptibility testing is not available, combination therapy with antibiotics such as piperacillin/tazobactam and metronidazole may be considered 6.