Adult Outpatients: Urogenital Infections: Vaginitis


Doses provided in this table are for patients with normal renal and hepatic function. Click on drug link to go to dosing guidelines.  Some antimicrobials are restricted (ID-R).  Click on link for guidelines on obtaining authorization.


Common Pathogens

Drug(s) of First Choice

Alternative Drug(s)


Candidal Vaginitis

Candida albicans

Fluconazole 150 mg PO x 1 dose

Miconazole 2% cream 5 g intravaginally x 3 days


Miconazole 100 mg suppository, one suppository daily x 7 days


Clotrimazole 1% cream 5 g intravaginally x 7-14 days

Single dose topical therapies are available but are less effective.


Seven day regimens are not superior to 3 day regimens.

Protazoan Vaginitis

Trichomonas vaginalis Metronidazole 2 g PO x 1 dose  Metronidazole 500 mg PO BID x 7 days 

In treatment failures to metronidazole, retreat with metronidazole 500 mg PO BID x 7 days. 


Bacterial Vaginitis

Gardnerella, other anaerobes

Metronidazole 500 mg BID PO x 7 days


Metronidazole vaginal gel 0.75%, 5 g intravaginally daily x 5 days


Clindamycin vaginal cream 2%, 5 g intravaginally daily x 7 days  

Clindamycin 300 mg PO BID X 7 days


Clindamycin ovules 100 mg intravaginally daily x 3 days