A female patient presents with a vaginal discharge that has a fishy odor. What is the treatment of choice for bacterial vaginosis?

Bacterial vaginosis (BV) is characterized by an overgrowth of specific bacteria in the vagina, leading to symptoms such as a thin, grayish-white discharge with a fishy odor, especially after sexual intercourse or during menstruation. The treatment of choice for BV is metronidazole, which is an antibiotic effective against the anaerobic bacteria involved in this condition.

Metronidazole works by disrupting the DNA synthesis of the bacteria, effectively reducing the population of the harmful organisms that contribute to the imbalance in the vaginal flora. It can be administered orally or vaginally, providing flexibility in treatment options based on patient preference and clinical circumstances.

In contrast, treatments like nonoxynol-9, ceftriaxone, and clotrimazole are not appropriate for bacterial vaginosis. Nonoxynol-9 is a spermicide and does not address the underlying bacterial infection. Ceftriaxone is a broad-spectrum antibiotic typically used for other sexually transmitted infections like gonorrhea and is not indicated for bacterial vaginosis. Clotrimazole is an antifungal, which is effective for yeast infections but does not target the bacterial flora associated with BV.

The effectiveness of metronidazole in treating bacterial vaginosis has