Instructions: Read the scenario and answer the following questions:
R.S. is a 32-year-old Caucasian woman who seeks treatment for a vaginal discharge that she has had for the past month. She is sexually active and has had the same partner for the past 6 months. She reports noticing an odor, especially after sexual intercourse. Her history reveals that she has been using a commercial douche on a bi-weekly basis during the past year for hygienic purposes in an attempt to prevent vaginal infections. She denies any other associated symptoms.
The physical examination reveals a white vaginal discharge. Microscopic examination of the vaginal discharge shows clue cells, and the pH is 5.5.
Diagnosis: Bacterial Vaginosis
- List specific goals of treatment for this patient.
- What drug therapy would you prescribe? Why?
- What are the parameters for monitoring the success of the therapy?
- Discuss specific patient education based on the prescribed therapy.
- List one or two adverse reactions for the selected agent that would cause you to change therapy.
- What would be the choice for second-line therapy? Provide rationale
- What OTC or alternative medications would be appropriate for this patient?
- What dietary or lifestyle changes should be recommended?
- Describe one or two drug–drug or drug–food interaction for the selected agent.