Drug of choice for bacterial vaginosis: March 2011
**Core Concept**
Bacterial vaginosis (BV) is a type of vaginal infection caused by an imbalance of naturally occurring bacteria in the vagina, leading to an overgrowth of various anaerobic bacteria. The condition is characterized by a decrease in the normal lactobacilli population, which is essential for maintaining vaginal pH and preventing infection.
**Why the Correct Answer is Right**
The drug of choice for treating bacterial vaginosis is metronidazole, a nitroimidazole antibiotic that works by inhibiting DNA synthesis in susceptible bacteria. Metronidazole penetrates the bacterial cell and causes cross-linking of DNA strands, ultimately leading to cell death. It is effective against anaerobic bacteria, such as Gardnerella vaginalis, which is commonly associated with BV.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not specify the correct antibiotic for treating bacterial vaginosis. Other antibiotics, such as amoxicillin-clavulanate, may not be effective for BV.
**Option B:** This option is incorrect because it is not a commonly used treatment for bacterial vaginosis. Other treatments, such as oral metronidazole or topical clindamycin, are more effective for BV.
**Option C:** This option is incorrect because it is not a first-line treatment for bacterial vaginosis. Other treatments, such as oral metronidazole, are more effective for BV.
**Clinical Pearl / High-Yield Fact**
It is essential to note that metronidazole is contraindicated in pregnant women, especially during the first trimester, due to potential teratogenic effects.
**Correct Answer: C. Metronidazole**