Gardnerella vaginalis:
- Gram-variable-staining rod, facultative anaerobic bacteria (actually has a Gram-positive cell wall, but because the cell wall is so thin it can appear either Gram-positive or Gram-negative under the microscope).
- Small (1-1.5 µm diameter) non-spore forming, non-motile coccobacilli.
- Previously classified as Haemophilus vaginalis and afterwards as Corynebacterium vaginalis.
- Growth: grows as small, circular, convex, gray colonies on chocolate agar; it also grows on HBT agar.
- Can cause bacterial vaginosis in some women as a result of a disruption in the normal vaginal microflora.
- Typically isolated in genital cultures. May also be detected in other samples from blood, urine, and pharynx.
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Important considerations: The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions. Generally, the most common agents/regimens are listed first.
- Metronidazole 500 mg orally twice daily x 7 days
- Metronidazole gel 0.75 percent (one applicatorful ) intravaginally once or twice daily for five days. If administered once daily, use at bedtime.
- Clindamycin 2% cream (Cleocin ®) (one full applicator) intravaginally at bedtime for 3 or 7 days in nonpregnant patients or for 7 days in pregnant patients
OR Insert one ovule (suppository – 100 mg clindamycin) intravaginally at bedtime x 3 days.
- Clindamycin 300 mg orally twice daily x 7 days
- Tinidazole 2 grams orally x 2 days OR Tinidazole 1 gram orally once daily x 5 days
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