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Bacterial Vaginosis Management - Treatment

This treatment plan reviews the risks and benefits of the treatment we are recommending. Please make sure to read it and the manufacturer's pamphlet that comes with the medicine. The manufacturer's pamphlet contains full information on potential medication interactions, side effects, and other important information you should know about the medicine before you start.

Instructions

You have stated that you wish to obtain treatment for bacterial vaginosis (vaginitis) with oral Clindamycin. You are to take 1 Tablet (300mg) 2 times each day (morning and evening, approximately 12 hours apart) for 7 days.

This treatment will decrease the overgrowth of this bacteria, which commonly lives in women’s genital organs. Signs of this infection include foul-smelling discolored discharge without itching or burning with urination. Bacterial vaginosis should not cause pain or discomfort during intercourse and cannot be transmitted between male/female sexual partners. It can be transferred between female/female sexual partners, but colonization does not mean overgrowth.

This bacteria can cause inflammation making you more susceptible to other STIs or pelvic inflammatory disease.

Please note, there is a black box warning on this antibiotic due to the risk for Clostridium difficile that can require hospitalization for complications. In response to these concerns, we reserve treatment with Clindamycin for specific use cases and recommend alternative antibiotics that are both effective and have a better safety profile

Allergies

This medicine, like all medications, may cause an allergic reaction if you are allergic to similar medicines or components. If you are allergic to any of the following please do not take the medicine and call or message us or see your doctor in person.

• Clindamycin
• Lincomycin
• Cleocin
• Cleocin Phosphate
• Tartrazine
  
  

Conditions

We have evaluated your health history and the specific health information you provided us, however if anything changes and you develop one of these conditions, please stop taking this medicine and call or message us immediately. This list may not be all inclusive.

• Pregnancy
• Liver problems or conditions
• Kidney problems or conditions
• Blood disorders
• Colitis or other gastrointestinal disease
  
  

Pregnancy and Breastfeeding

Clindamycin is a pregnancy class B medication. It crosses the placenta and has not been associated with an increased frequency of congenital abnormalities. While Clindamycin is safe, bacterial vaginosis during pregnancy can cause risks to your pregnancy. You should see your provider overseeing your pregnancy for you and your baby’s safety.

Clindamycin is present in breastmilk and has the potential to cause adverse effects on the breastfed infant's gastrointestinal flora.Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis.

Emergency Side Effects

This medicine can cause dangerous and potentially life threatening side effects. If any of the emergency side effects listed in the manufacturer's pamphlet or those below happen to you please stop taking the medicine and call 911 or seek immediate medical help in-person:

• Colitis: [US Boxed Warning]: Can cause severe and possibly fatal colitis. Should be reserved for serious infections where less toxic antimicrobial agents are inappropriate.
• Anxiety or agitation
• Difficulty swallowing or throat swelling
• Jaundice or yellow skin
• Severe skin rash or changes
• Severe weakness or fatigue
• Shortness of breath or wheezing
  
  

Other Side Effects

This medicine can also cause other side effects including (this list is not all inclusive):

• Abdominal pain
• Dizziness
• Headache
• Nausea
• Vomiting
• Diarrhea
• Vaginal infections
  
  

Medicines, Supplements, and Foods

We have evaluated the specific health information you provided us, however if you are taking any of the medicines, foods, or supplements listed below call or message us before you take the medicine. Some of these can cause dangerous interactions with the medicine we are prescribing you and we will help you evaluate that risk and decide on an appropriate treatment plan. Please ensure your chart is up to date with your current medications, allergies, and medical conditions so your provider can safely treat you as this list may not be all inclusive.

• Erythromycin
• Neuromuscular blocking agents
• Itraconazole
• Ritonavir
• Clarithromycin
  
  

If you received Fluconazole along with your bacterial vaginosis treatment, please finish your bacterial vaginosis treatment first. If you notice symptoms of a vaginal yeast infection, like persistent itching or thick white discharge during or after treatment, you can start your Fluconazole treatment once you've completed the bacterial vaginosis treatment.

Risks

Accurate Information

We have evaluated your health history and your specific health information you provided and determined it is safe to proceed with this treatment at this time. If your health history changes including diagnoses or medications please message or call us before you take the medicine to ensure it's safe to proceed. Some medications and conditions can cause dangerous interactions with the medicine we are prescribing and we will help you evaluate that risk and decide on an appropriate treatment plan.

Treatment Failure

This treatment is not guaranteed to be effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If the treatment is not working, or if you are experiencing new or worsening symptoms, give us a call or message us anytime. If it is an emergency, call 911 or seek immediate medical help in person. You may need to seek alternative treatment such as those listed below or in the follow up plan.

Misdiagnosis or Delayed Diagnosis

Through telehealth, there is also a risk that we misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. This risk exists with a doctor in person as well but they may have additional resources to aid their evaluation. We use evidence-based practice and guidelines as well as clinical decision-making to minimize these risks.

Accepting or Declining Our Recommendation

We have based our recommendation on your specific case and medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can’t provide. Message us or talk to your doctor in person to discuss alternative treatments.

Alternative Treatment

We have based our recommendation on your specific case and medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can't provide. Message us or talk to your doctor in-person to discuss alternative treatments. Here are some other treatments or strategies that you might consider:

• In-person Pelvic exam with testing
  
  

Share with Your In-Person Healthcare Team

You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.

You can also ask us questions anytime and we are happy to help you share any information about your health with your in-person healthcare team.