Diagnosis of bacterial vaginosis
Any woman who thinks she may have BV (or other vaginal infection) should see a doctor for an accurate diagnosis, which will ensure she gets the most targeted, effective treatment.
The first step in diagnosing a BV infection is a physical exam. Your doctor will ask you about your symptoms, perform a pelvic exam to look for signs of BV, and take a sample of vaginal fluid for clinical testing.
A specific set of clinical criteria known as "Amsel's criteria" is used to definitively diagnose BV. If 3 of these 4 criteria are found to be present, a BV diagnosis is confirmed:1,2
- Abnormal gray discharge
- Vaginal pH greater than 4.5
- A positive test for amine ("fishy") odor
- Microscopic identification of epithelial cells with more than 20% appearing as "clue" cells (cell margins obscured by bacteria)
Your doctor may also need to perform additional clinical tests to rule out infection with other organisms (such as Trichomonas vaginalis, which causes trichomoniasis), since the symptoms of some vaginal infections may be similar.
Some women have BV but do not experience symptoms. If you think you may be at risk, it is important to be tested and treated.3
According to the Centers for Disease Control, untreated BV may increase a woman's susceptibility to sexually transmitted diseases (STDs) such as Chlamydia, gonorrhea, and HIV.
Important Safety Information
WARNING: POTENTIAL RISK FOR CARCINOGENICITY
Carcinogenicity has been seen in mice and rats treated chronically with metronidazole, another nitroimidazole agent. Although such data have not been reported for tinidazole, the two drugs are structurally related and have similar biologic effects. Its use should be reserved for the conditions described in INDICATIONS AND USAGE.
Contraindications
- Prior history of hypersensitivity to tinidazole or other nitroimidazole derivatives
- First trimester of pregnancy
- Nursing mothers, unless breast-feeding is interrupted during tinidazole therapy and for 3 days following the last dose
Warnings and Precautions
- Seizures and neuropathy have been reported. Discontinue Tindamax if abnormal neurologic signs develop
- Vaginal candidiasis may develop with Tindamax and require treatment with an antifungal agent
- Use Tindamax with caution in patients with blood dyscrasias. Tindamax may produce transient leukopenia and neutropenia
Adverse Reactions
Most common adverse reactions for a single 2 g dose of tinidazole (incidence >1%) are metallic/bitter taste, nausea, weakness/fatigue/malaise, dyspepsia/cramps/epigastric discomfort, vomiting, anorexia, headache, dizziness and constipation. To report SUSPECTED ADVERSE REACTIONS, contact Mission Pharmacal Company at 1-800-298-1087 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch
This material is intended to provide basic information. Patients should discuss all medical advice, diagnosis, and treatment with their healthcare provider.
Please see full Prescribing Information
- Vaginitis. ACOG Practice Bulletin No. 72. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2006;107:1195-206.
- Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station, NJ: Merck Research Laboratories;1999:1254-8.
- Sweet RL. Gynecologic conditions and bacterial vaginosis: implications for the non-pregnant patient. Infect Dis Obstet Gynecol. 2000;8(3-4):184-90.
For Health Professionals
Only Tindamax® is approved to treat both bacterial vaginosis and trichomoniasis (TV).
Clinical Insight
Oral vs vaginal cream therapy: Patient preference for oral dosing is demonstrated to be 84%. More»
Beyond BV
Tindamax® may be prescribed for other infections including:
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