Can Amoxicillin Treat Bacterial Vaginosis (BV)?

Bacterial vaginosis, or BV, is a type of vaginal infection caused by bacterial changes within the vagina. [1] This includes overgrowth in bacteria that are already native to the vaginal microbiome, such as Gardnerella, Prevotella, Mobilincus, Megaspahera, and Sneathea species. [2]

Though it is possible for BV to present with no symptoms, women and people assigned female at birth (AFAB) with bacterial vaginosis will typically experience unusually colored discharge, itching and/or irritation, and discharge that has a strong smell. [1]

Fortunately, prescribed antibiotic treatment can help get rid of the bacterial infection and rebalance the normal flora within the vagina. [1] That said, can amoxicillin treat BV? Let’s explore.

Understanding Amoxicillin

Amoxicillin is a penicillin antibiotic, meaning it belongs to the beta-lactam class of antibiotics. This class of antibiotics works by preventing bacteria from making the cell wall needed for them to live. This kills the bacteria and prevents them from reproducing. [3]

Most commonly, healthcare providers prescribe amoxicillin to treat [4]:

• Chest infections, like pneumonia
• Dental infections
• Stomach ulcers
• Ear infections

It’s available in capsule, tablet, and liquid forms that you take by mouth, and can be prescribed as injection for severe cases [3,5]

While amoxicillin can be used to treat bacterial vaginosis, it’s typically less effective than other antibiotics. In most cases, amoxicillin is prescribed for bacterial vaginosis when other antibiotics for BV treatment should be avoided due to a patient’s medical condition, such as pregnancy. [6]

Treatment Options For Bacterial Vaginosis

To treat bacterial vaginosis, healthcare providers will prescribe one of two gel or cream antibiotics: metronidazole or clindamycin. Your healthcare provider may also prescribe these antibiotics as an oral form that you swallow. [1]

People with a BV infection typically take these medications for up to seven days. [1]

Metronidazole

Metronidazole vaginal gel is available as a generic and also sold under brand names MetroGel®, MetroGel Vaginal®, MetroGel-Vaginal®, NUVESSA®, and Vandazole®. [5,7]

To apply it properly, follow the instructions on the label. You’ll want to wash your hands before use and then squeeze the gel onto the provided applicator. For easy application, lie on your back and insert the applicator into the vagina before releasing the gel. [7]

Additionally, never stop using an antibiotic unless advised by your healthcare team, as this can lead to incomplete treatment of the BV infection and increase your risk of getting future vaginal infections. [1,7]

It’s important to also note that metronidazole may interact with substances and medications, including but not limited to [7]:

• Alcohol
• Cisapride
• Disulfiram
• Dronedarone
• Pimozide
• Thioridazine

Patients may also experience adverse side effects, such as [7]:

• Allergic reactions, including rashes, itching, hives, and swelling of the face, tongue, lips, or throat
• Cognitive issues, such as dizziness, loss of coordination, confusion, and difficulty speaking
• Changes in heart rhythm, which may cause dizziness, chest pain, or breathing troubles
• Liver injury, evident by upper belly pain, loss of appetite, nausea, yellowing skin or white part of the eyes, and fatigue
• Pain or numbness in the hands and feet

Clindamycin

Clindamycin vaginal cream is another antibiotic that can treat bacterial vaginosis. Brand names include Cleocin® and Clindesse®. [8]

Like metronidazole, clindamycin comes with an applicator that you will insert directly into the vagina. Unlike metronidazole, interactions with other substances and medications are not common. However, it’s still important to talk with your healthcare provider about any medications you take. [8]

While on this medication, it’s advised to avoid sex and vaginal products like tampons and douches, as they may interfere with the effectiveness of the medication. Cllindamycin gel can also damage latex forms of contraception, such as condoms and diaphragms. It’s advisable to avoid using these products while you’re using this medication and for three days after finishing your treatment. [8]

Side effects with clindamycin gel can include: [8]

• Allergic reactions
• Severe diarrhea
• Fever
• Unusual vaginal discharge
• Vaginal irritation

How to Prevent Bacterial Vaginosis

Fortunately, antibiotics can treat bacterial vaginosis. That said, there are steps that you can take to reduce the risk of bacterial overgrowth and help prevent BV altogether. [1]

Before diving into prevention methods, it’s important to note that 84% of bacterial vaginosis cases are asymptomatic, meaning patients don’t experience any symptoms. And in some cases, bacterial vaginosis will go away on its own (though we always advise seeking advice from a medical professional if you suspect you have BV or any medical condition). [1]

All that said, to lower your risk of bacterial vaginosis, you can adopt these habits [1]:

• Avoid douching – Douching can disrupt the natural balance of bacteria in the vagina, making it more susceptible to a vaginal infection like bacterial vaginosis.
• Avoid anal bacteria – Bacteria from the anus can be introduced into the vagina during sexual activity or improper hygiene. To lower the risk of bacterial vaginosis, it's important to avoid transferring bacteria from the anus to the vagina.
• Limit your number of sex partners – Having multiple sex partners increases the risk of bacterial vaginosis. Limiting the number of sexual partners can help reduce the likelihood of exposure to bacteria that may contribute to the development of bacterial vaginosis.
• Use latex condoms or dental dams – Consistent and correct use of latex condoms or dental dams during sexual activity can help reduce the risk of bacterial vaginosis by preventing the exchange of bodily fluids and reducing the transmission of bacteria.
• Wear cotton underwear – Cotton underwear allows for better air circulation and helps keep the vaginal area dry, which can discourage the growth of bacteria that contribute to bacterial vaginosis. Avoiding tight-fitting underwear made from synthetic materials can also be beneficial.

Access Easy and Discreet BV Treatment Options Through Everlywell

If you’re experiencing recurrent BV symptoms, it’s best to visit a healthcare provider who can prescribe an antibiotic to treat the harmful bacteria.

For a convenient option, Everlywell provides bacterial vaginosis treatment online that requires no appointment in many states. Simply fill out a medical intake questionnaire and, if applicable, a licensed Everlywell healthcare provider can prescribe the antibiotic that works best for your situation.

Don’t wait. Get care today.

1. Bacterial Vaginosis (BV). Cleveland Clinic. Accessed May 15, 2024. Medical Citation URL.
2. Bacterial Vaginosis. WHO. Accessed May 15, 2024. Medical Citation URL.
3. Pandey N, Cascella M. Beta-Lactam Antibiotics. StatPearls. Accessed May 25, 2024. Medical Citation URL.
4. Amoxicillin. NHS. Accessed May 15, 2024. Medical Citation URL.
5. Food and Drug Administration. Orange Book: approved drug products with therapeutic equivalence evaluations. Accessed May 28, 2024. Medical Citation URL.
6. Antibiotics and Bacterial Vaginosis. Rev Fr Gynecol Obstet. Accessed May 15, 2024. Medical Citation URL.
7. Metronidazole Vaginal Gel. Cleveland Clinic. Accessed May 15, 2024. Medical Citation URL.
8. Clindamycin Vaginal Cream. Cleveland Clinic. Accessed May 15, 2024. Medical Citation URL.