{ "schema_version": 1, "kind": "condition", "id": "bacterial-vaginosis", "name": "Bacterial vaginosis", "category": "infectious", "sources": "Vaginitis - disease-level clinical article (vaginitis-nonspecific-clinical.txt) · CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Bacterial Vaginosis - Recommended Regimens · CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Bacterial Vaginosis - Recommended Regimens (2% cream) and Alternative Regimens (300 mg oral)", "review_status": "reviewed", "verified_against": "Vaginitis - disease-level clinical article (vaginitis-nonspecific-clinical.txt) · CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Bacterial Vaginosis - Recommended Regimens · CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Bacterial Vaginosis - Recommended Regimens (2% cream) and Alternative Regimens (300 mg oral)", "verified_date": "2026-08", "treatments": [ { "id": 244, "generic": "Metronidazole", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 mg BID orally", "adult_duration": "7 days", "dose_source": "Vaginitis - disease-level clinical article (vaginitis-nonspecific-clinical.txt), Recommended Regimens According to the Centers for Disease Control and Prevention, Bacterial vaginosis: \"Metronidazole 500 mg orally twice daily for 7 days\". This is the held copy of the CDC 2021 regimen; the CDC guideline itself is not cached here.", "rationale": "Gold-standard oral nitroimidazole regimen with high cure rate", "cautions": [ "Common side effects include metallic taste, nausea, and dark urine.", "PREGNANCY - the CDC 2021 guideline puts no trimester restriction on it: \"Pregnant women can be treated with any of the recommended regimens for nonpregnant women\", and \"metronidazole therapy poses low risk during pregnancy\" because \"no evidence of teratogenicity or mutagenic effects among infants has been reported\". Two trials proved 250 mg three times daily effective in pregnancy; 500 mg twice daily \"can also be used\". BREASTFEEDING - lower doses \"are considered compatible with breastfeeding\", and after a single 2 g dose some clinicians defer the feed for 12-24 hours.", "ALCOHOL - the CDC 2021 guideline reviewed the evidence and found abstinence unnecessary. It found \"no in vitro studies, animal models, reports of adverse effects, or clinical studies providing convincing evidence of a disulfiram-like interaction between alcohol and metronidazole\", notes that \"Metronidazole does not inhibit acetaldehyde dehydrogenase, as occurs with disulfiram\", and concludes: \"Thus, refraining from alcohol use while taking metronidazole (or tinidazole) is unnecessary.\"" ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Pre-pubertal bacterial vaginosis is rare; evaluate for child abuse", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DUMOZOL 500MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > ALPHARMA-DENMARK", "price_egp": 7.0, "pack_count": 20, "unit_price": 0.35, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZOLGUARD 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 9.0, "pack_count": 20, "unit_price": 0.45, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NITROFECTAZOLE 500 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GYPTO PHARMA", "price_egp": 10.5, "pack_count": 20, "unit_price": 0.53, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLAGICURE FORTE 500 MG 20 F.C. TAB", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 23.0, "pack_count": 20, "unit_price": 1.15, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRICHOGYL 500MG 12 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 15.0, "pack_count": 12, "unit_price": 1.25, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLAGELLAT FORTE 500MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 30.0, "pack_count": 20, "unit_price": 1.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GEDAZOLE 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS", "price_egp": 34.0, "pack_count": 20, "unit_price": 1.7, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METROGYPTON 500 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GYPTO PHARMA", "price_egp": 34.0, "pack_count": 20, "unit_price": 1.7, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUMOZOL 125MG/5ML SUSP. 125ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > ALPHARMA-DENMARK", "price_egp": 5.75, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "METROZOLE 125MG/5ML SUSP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 19.5, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "bacterial-vaginosis" }, { "id": 245, "generic": "Clindamycin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 300.0, "adult_dose": "300 mg BID orally (or 2% vaginal cream at bedtime for 7 days)", "adult_duration": "7 days", "dose_source": "CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Bacterial Vaginosis - Recommended Regimens (2% cream) and Alternative Regimens (300 mg oral)", "rationale": "Alternative oral treatment for patients allergic or intolerant to metronidazole", "cautions": [ "Vaginal cream formulation may weaken latex condoms.", "Discontinue immediately if severe diarrhea occurs.", "There is a risk of Clostridioides difficile pseudomembranous colitis." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric evaluation required", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "ADCOCLINDACE 300 MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 24.0, "pack_count": 16, "unit_price": 1.5, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINACYN 300MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > EGYPTIAN PHARMACISTS COMPANY", "price_egp": 31.5, "pack_count": 16, "unit_price": 1.97, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINDAM 300 MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > OCTOBER PHARMA", "price_egp": 75.0, "pack_count": 16, "unit_price": 4.69, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEPACLIND 300MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEPACO", "price_egp": 38.0, "pack_count": 8, "unit_price": 4.75, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINDACINE ART 300 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > ART PHARMA", "price_egp": 76.0, "pack_count": 12, "unit_price": 6.33, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALFACLINDAMYCIN 300 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATCO PHARMA > ROTABIOGEN", "price_egp": 69.0, "pack_count": 10, "unit_price": 6.9, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DALACIN C 300MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 114.0, "pack_count": 10, "unit_price": 11.4, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KLENDABIOTICAM 1 % TOP. SOLUTION", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PANAX PHARMA", "price_egp": 8.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ADCOCLINDACE 10MG/ML TOP. SOL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "bacterial-vaginosis" }, { "id": 246, "generic": "Secnidazole", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "2 g by mouth as a single dose", "adult_duration": "Single dose", "dose_source": "CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Bacterial Vaginosis - Alternative Regimens - verbatim: \"Secnidazole 2 g oral granules in a single dose\"", "rationale": "One dose, taken in front of you if need be. On a disease whose 7-day courses are often not finished, that is the practical advantage, and a course is a few tens of pounds.", "cautions": [ "The guideline names oral granules. Egypt sells secnidazole as 500 mg and 1 g tablets instead, so the 2 g dose is four 500 mg tablets or two 1 g tablets taken together.", "Avoid in pregnancy and breastfeeding. The CDC says data are insufficient on secnidazole in pregnancy and that its use should be avoided - metronidazole is the option there.", "One dose does not shorten the follow-up: symptoms that persist or return need the diagnosis confirmed again rather than a repeat prescription." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Bacterial vaginosis is a disease of women of reproductive age; the guideline sets no paediatric dose.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "SECNIDA-MISR 500MG 4 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 11.0, "pack_count": 4, "unit_price": 2.75, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SENIDAL 500MG 4 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 11.0, "pack_count": 4, "unit_price": 2.75, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EUROZOLE 500MG 4 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 11.5, "pack_count": 4, "unit_price": 2.88, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLAGENTYL 500MG 4 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 21.6, "pack_count": 4, "unit_price": 5.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLADAZOLE 500MG 4 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 26.0, "pack_count": 4, "unit_price": 6.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OPINIDAZOLE 1000MG 8 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 84.0, "pack_count": 8, "unit_price": 10.5, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMEBAZOL 1 GM 2 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGYPHAR", "price_egp": 27.0, "pack_count": 2, "unit_price": 13.5, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CIPAZOLE FORT 1 GM 2 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > ASPIN PHARMACEUTICAL", "price_egp": 27.0, "pack_count": 2, "unit_price": 13.5, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "bacterial-vaginosis" }, { "id": 247, "generic": "Tinidazole", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "2 g once daily for 2 days, or 1 g once daily for 5 days", "adult_duration": "2 days at 2 g, or 5 days at 1 g", "dose_source": "CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Bacterial Vaginosis - Alternative Regimens - verbatim: \"Tinidazole 2 g orally once daily for 2 days\" and \"Tinidazole 1 g orally once daily for 5 days\"", "rationale": "The cheapest course on the card - four 500 mg tablets is about 8 EGP - and a shorter one than the seven days of metronidazole.", "cautions": [ "Not in pregnancy. The CDC is explicit that animal data show moderate risk and that tinidazole should be avoided in pregnancy; metronidazole is the one with the safety record there.", "Egyptian packs are 500 mg tablets, so the 2 g dose is four tablets taken together and the 1 g dose is two.", "Where metronidazole or tinidazole cannot be used at all, the CDC prefers intravaginal clindamycin cream." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Bacterial vaginosis is a disease of women of reproductive age; the guideline sets no paediatric dose.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "FASIGYN 500 MG 4 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 8.35, "pack_count": 4, "unit_price": 2.09, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROTOZOLE 500 MG 12 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 39.0, "pack_count": 12, "unit_price": 3.25, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "bacterial-vaginosis" } ] }