Iningi labantu abasebenzisa i-metronidazole gel ye-BV libona ukuncipha kwephunga kanye nokukhishwa okungasindi phakathi nezinsuku ezingu-2 kuye kwezingu-3, kodwa ukwelashwa kuthatha imiyalelo egcwele yezinsuku ezingu-5, futhi izimpawu ngokuvamile ziyahamba phakathi nezinsuku ezingu-5 kuye kwezingu-7. Ukuthola usizo ebusuku besithathu akulona ubufakazi bokuthi isifo sesihambile. Qedela yonke imiyalelo emihlanu noma kunjalo.

I-TL;DR: Okubalulekile okubalulekile

  • Indlela ejwayelekile: i-gel engu-0.75%, isisetshenziswa esisodwa esigcwele (5 g) ngaphakathi esithweni sangasese kanye ngosuku ngaphambi kokulala imiyalelo emihlanu.
  • Iphunga lezinhlanzi liyanyamalala kuqala, ngokuvamile ebusuku besibili. Umthamo wokukhishwa kanye nokwakheka yizinto zokugcina ezibuyela esimweni esivamile.
  • Ayikho ushintsho nhlobo ngosuku lwesithathu kufanele kuqashelwe njengokuthumela umlayezo kudokotela. Isengaphathwa izimpawu ezinsukwini ezimbili ngemuva komthamo wokugcina, lokhu ukwehluleka kokwelashwa, hhayi ukuqhubeka kancane.
  • Ukukhishwa okujiyile noma okunezingqimba phakathi kwenkambo ngokuvamile kuyi-gel ekhishiwe. Engeza ukulunywa nokushiswa futhi kungase kube ukutheleleka ngamagciwane esikhundleni salokho.
  • Izimpawu ezibuyayo emavikini kamuva ziwukubuya, okuyinto ejwayelekile futhi ephathwa ngendlela ehlukile kunokwehluleka.

Iningi labantu libona iphunga elincane ezinsukwini ezingu-2 kuye kwezingu-3 ngemuva kokuqala kwe-metronidazole gel ye-BV

I-Metronidazole gel ye-BV inikezwa njenge-gel engu-0.75%, isisetshenziswa esisodwa esigcwele (5 g) sifakwa esithweni sangasese kanye ngosuku izinsuku ezingu-5. Iphunga nokukhishwa ngokuvamile kuqala ukuthambisa phakathi kwezinsuku ezingu-2 kuye kwezingu-3, futhi iningi lokuthola usizo lwezimpawu lifika ekupheleni kwenkambo. Izinombolo ezithathwe emihlahlandleni yokwelashwa ye-CDC zibeka ukuhlanzwa okuphelele kwezimpawu ze-BV cishe ezinsukwini ezingu-5 kuye kwezingu-7.

Le ngaziselo ivela ngqo emihlahlandleni yokwelashwa kwe-CDC 2021 STI yokwelashwa kwe-bacterial vaginosis, ebala i-intravaginal metronidazole gel kanye ngosuku izinsuku ezingu-5 njengenketho yomugqa wokuqala enconyiwe. Uma ikhemisi lakho likunikeze ibhokisi elinamalulwengu i-MetroGel-Vaginal futhi umngani wakho athole i-tube enamalulwengu i-metronidazole vaginal gel 0.75%, nonke ninomuthi ofanayo ngamandla afanayo.

Lapho ufika khona ngaphakathi kwesikhathi sezinsuku ezingu-5 kuye kwezingu-7 akulona okungahleliwe. Izinto ezimbili ziyayihambisa: ubukhulu bezimpawu zakho lapho uqala, nokuthi i-BV iqhubeke isikhathi esingakanani ngaphambi kokuba uqale ukuyelapha. Umuntu oqede incwadi kadokotela emuva kwezinsuku ezimbili zephunga uvame ukuzizwa ejwayelekile ngokushesha kunezinye ezilinde amasonto amathathu.

Ukuzizwa kangcono ngosuku lwesithathu akufani nokwelashwa

Umbuzo "kuthatha isikhathi esingakanani i-metronidazole gel ukusebenza kwe-BV" ufihla izimpendulo ezimbili ezihlukene. Ukuthola usizo lwezimpawu kulinganiswa ezinsukwini. Ukwelashwa kwe-Microbiological kulinganiswa emavikini, futhi akukanikezwa isiqiniseko.

Nansi into amakhasi amaningi angafanele akutshele yona: izinombolo zokwelashwa ziyancipha ngokuhamba kwesikhathi. Esesifundweni esiqhathanisiwe esenziwe ngokungahleliwe se-intravaginal metronidazole gel, 79% abesifazane belashwe ngempumelelo kuvakashe yokuqala yokulandelela, ezinsuku ezingu-12 kuye kwezingu-16 ngemuva kokuqala ukwelashwa. Ngevakashe yokugcina ezinsuku ezingu-28 kuye kwezingu-35, 66% kuphela ababesenemizwa. Umuthi wasebenza. Bese, cishe kwabanye kwabashiyagalombili kwabesesilwane owesifazane ababelashwe ngempumelelo, i-vaginal flora yabuya. Ngakho-ke, qedela yonke imiyalelo emihlanu noma ngabe iphunga selihambile ebusuku besibili. Ukuyeka kusenesikhathi ngoba uzizwa ulungile kuyimbangela ejwayelekile yokubuya okusheshayo, futhi ingagwenywa ngokuphelele. I-CDC ibeka i-BV njengento ejwayelekile ukuqhubeka noma ukubuyeka, okuyinye indlela yokusho ukuthi lesi yisimo osiphatha kunokuba leso osivala ngaso incwadi.

Iphunga lezinhlanzi liyadlula kuqala, futhi ukukhishwa yikona kokugcina okubuyela esimweni esivamile

Izimpawu zokuqala ze-metronidazole gel eziqala ukusebenza kwe-BV zivela emakhaleni akho, hhayi kwipentshonye lakho. Nansi imikhuba ongayilindela:

  • Ubusuku 1 kuye kwezingu-2: iphunga lezinhlanzi liyancipha, ikakhulukazi iphunga elibukhali elilandelayo ucansi.
  • Usuku lwesithathu: umthamo wokukhishwa uyancipha futhi uyancipha, futhi noma yikuphi ukushiswa noma ukucasuka kwangaphandle kuyaqala ukuthambisa.
  • Usuku lwesihlanu kanye nezinsuku ezingu-2 kuye kwezingu-3 ngemuva komthamo wokugcina: ukukhishwa kufanele kubukeke futhi kunuke eduze kwesisekelo sakho sangempela.

Sebenzisa usuku lwesithathu njengesheke langempela. Ukuthuthuka okuyingxenye ngaleso sikhathi kulungile futhi kulindelekile. Ayikho ushintsho nhlobo ephunga ngosuku lwesithathu yisizathu sokuxhumana nodokotela kunokuba uthembe buthule ukuthi ebusuku obubili bokugcina buyolungisa.

I-note eyodwa ewusizo nge-schedule yansuku zonke: inikezwa ngaphambi kokulala ngoba ukulala amahora ambalwa kugcina i-gel lapho kufanele khona futhi kunciphisa ukuvuza emini. I-panty liner iseyasiza.

Lokho kukhishwa okujiyile, okunengqimba cishe ngosuku lwesithathu kuvame ukuba yi-gel, hhayi ukutheleleka okusha

Ukukhishwa okujiyile ngemuva kwe-metronidazole gel, okuvame ukuqala ebusuku besithathu, kungenye yezinto eziningi ezaziwa kakhulu abanesifo abachaza futhi okunye okungachazwanga kangako. Ababuyekezi emakhasini okubuyekezwa kwemithi yesifo babika lokhu ngokuphindaphindiwe, futhi bayichaza njengokuhamba phakathi kwezinsuku ezimbalwa zomthamo wokugcina. Phatha lokho njengomuzwa obikwe yisifo, hhayi njengesiphetho sokwelashwa.

Indlela okungenzeka ukuthi kulungile ayisiyo imbangela kodwa i-microbial. Isisekelo se-gel siyaxubana nokukhiqiza okujwayelekile futhi siyakhishwa kancane kancane, ngakho kokubili umthamo kanye nokwakheka kuyashintsha phakathi nenkambo.

Umugqa obalulekile ukuthi yini ehambisana nayo. Ukukhishwa okumhlophe, okunezingqimba, okufana ne-cottage cheese okuhambisana nokulunywa nokushiswa, ngenkathi iphunga lezinhlanzi manje selingekho, kukhombisa ukutheleleka ngamajoyina esikhundleni salokho, okungahle kubangelwe ama-antibiotics. Ukushintsha kokwakheka kungabhekwa. Ukushintsha kokwakheka nokulunywa okusha noma ukushiswa kufanele kuqashelwe.

Ukuphinda kabili ukusebenzisa kanye ngosuku ngeke kukwenze uphile ngokushesha

Ngingasebenzisa i-metronidazole gel kabili ngosuku ye-BV? Hhayi ngezimfuno zakho. I-CDC incoma u-5 g kanye ngosuku izinsuku ezingu-5, futhi lapho umdokotela enikeza ngokukhethekile i-schedule ephindwe kabili ngosuku, inkambo iseyizinsuku ezingu-5, ngakho umugqa wokugcina awuhambi.

Lokho i-gel eyengeziwe ekuthengelayo kuyithuba eliphakeme lokucasuka kwasendaweni kanye nengozi yangempela yokuphela kwezisebenzisi ngaphambi kobusuku besihlanu. I-FDA prescribing information ye-metronidazole vaginal gel 0.75% ikuyala ukuthi ulahle isisetshenziswa ngemuva kokusetshenziswa ngakunye bese uvula esisha somthamo olandelayo, ngakho-ke iphakethe libalwa ngemiyalelo oyinikiwe. Uma uphuthelwa ubusuku, yisebenzise lapho ukhumbula bese uyaqhubeka. Ungaphindi umthamo olandelayo. Isifiso esifanayo sibonakala nama-steroids aphezulu, lapho abantu befuna umkhiqizo omningi esikhundleni sezikhathi ezikhonjisiwe, futhi kubalulekile ukwazi ukuthi ungasebenzisa kangakanani i-triamcinolone ngokuphepha ngaphambi kokwenza lokho.

Isengaphathwa izimpawu ezinsukwini ezimbili ngemuva komthamo wokugcina? Lokho ukwehluleka, hhayi ukuqhubeka kancane

Yini okufanele uyenze uma i-metronidazole gel ingayisusi i-BV iqala ngosuku. Uma iphunga nokukhishwa kungashintshi cishe ezinsuku ezimbili ngemuva komthamo wakho wokugcina, cishe usuku lwesikhombisa, ukulinda okwengeziwe ngeke kusilondoloze. Inkambo isiphelile futhi umuthi wenze lokho okuzokwenza. Ubude benkambo yama-antibiotic bunqunywa yindlela kunokuba ngokuthi uzizwa kanjani, okuyisimiso esifanayo ngemuva kokuthi zingaki izinsuku okufanele uzithathe i-nitrofurantoin ye-UTI.

Izinkulumo ezimbili ziphelele. Noma kwakungeyona i-BV ukugcina (i-trichomoniasis, i-yeast, noma inhlanganisela kungabonakala) noma le nkinga idinga enye into ehlukile. Lindela ukuthi udokotela acabange nge-oral metronidazole 500 mg kabili ngosuku izinsuku ezingu-7, noma isigaba esihlukile njenge-clindamycin noma i-tinidazole, ekhetha ngokususelwa kumlando wakho nanoma yimaphi amayezobuyekezwa.

Uma udinga le ngxoxo ngokushesha, i-August's $39 online urgent care visit ikuxhumanisa nodokotela onelayisense lase-US ongabuyekeza izimpawu zakho nomlando wakho wokwelashwa futhi anikeze incwadi kadokotela lapho kufanele khona. Udokotela wenze leso sinqumo, hhayi ukubhuka. Yiba nombono ocacile ngemikhawulo: ukuvakasha nge-video akukwazi ukwenza ukuhlolwa kwesitho sangasese noma ukuqoqa iswubhu yesitho sangasese, ngakho-ke uma ukuxilongwa kungaqinisekile, ukuhlolwa komuntu kungase kube isinyathelo esidingekayo.

I-BV ebuya emavikini amathathu kamuva yizimpawu zokubuyeka, hhayi inkambo yehlulekile

I-BV ebuya ngemuva kokwelashwa yinkinga ehlukile kune-BV engazange ihambe, futhi izinto ezimbili zithola izinyathelo ezilandelayo ezihlukile. Isimiso esihlukanisayo silula: isikhathi esingazinazimpawu sezinsuku ezilinganiselayo ezimbili noma ngaphezulu, silandelwe ukuphinda kwephunga nokukhishwa, yikubuyeka. Ukungazange ukuthole ukuzizwa ungenazimpawu nhlobo yikwehluleka kokwelashwa, okuxoxwe esigabeni esingenhla.

Ukubuyeka kuyajwayelekile futhi kuqala kusenesikhathi. Leso sifundo sibonisa ukwehla kokwelashwa kusuka ku-79% ezinsuku ezingu-12 kuye kwezingu-16 kuya ku-66% ezinsuku ezingu-28 kuye kwezingu-35 yisinyathelo sokuqala sezinyanga. Izinombolo ezivame ukubalwa zibeka ukubuyeka cishe ku-30% phakathi nezinyanga ezintathu nangaphansi kwengxenye ezinyangeni eziyishumi nambili.

Izingxenye ezimbili zemihlahlandlela ye-CDC zifanele ukubanjwa. Okokuqala, ayikho i-test-of-cure visit edingekayo uma izimpawu zakho zihamba; ubuyela kuphela uma zibuya. Okwesibili, kubantu abanokubuyeka okuningi, i-metronidazole gel kabili ngesonto eqhubeka isikhathi esingaphezu kwezinyanga ezintathu kunciphisa ukubuyeka, ngomkhawulo owodwa obalulekile: ukuvikelwa kuyayeka lapho ukwelashwa okuphikisayo kuyayeka.

Ezinye izimpawu zisho ukuthi lokhu akulona i-BV elula futhi akufanele lindele inkambo yezinsuku ezingu-5

Shayela u-911 noma uye egumbini lezimo eziphuthumayo manje uma:

  • Uthola ukuvuvukala kobuso noma komphimbo, ubunzima bokuphefumula, noma ukuququda okusabalale kakhulu ngemuva kokusebenzisa i-gel.
  • Unezinga lokushisa noma umkhuhlane nobuhlungu obukhulu esiswini esingezansi noma esingezansi kwesisu, okungafanekisa isifo sokuvuvukala kwamathambo.

Bhukha ukuvakasha phakathi nesonto elilandelayo uma:

  • Ayikho intuthuko nhlobo ngosuku lwesithathu.
  • Usengaphathwa izimpawu ezinsukwini ezimbili ngemuva kokuqeda inkambo yezinsuku ezingu-5.
  • Izimpawu zibuyela phakathi kwezinsuku ezingu-2 kuye kwezingu-4 zokuqeda.
  • Une ukopha okusha okukhulu noma okungajwayelekile kwesitho sangasese.
  • Ucanisi kuba buhlungu kakhulu noma bubuhlungu.

Khuluma nodokotela ngaphambi kokuba uqale uma:

  • Ukhulelwe noma ungase ukhulelwe. I-BV ihlotshaniswa nengozi yokubeletha ngaphambi kwesikhathi futhi ifuna ukuhlolwa ngokushesha, hhayi isikhathi sokulinda nokubona.
  • Awuzange uhlolwe ngokusemthethweni i-BV futhi uzilapha wedwa.
  • Usebenzisa i-gel eyinsalela kusukela kudokotela owake wanikezwa.
  • Uke waba nezigameko ezintathu noma ngaphezulu ngonyaka odlule.

Imibuzo evame ukubuzwa

I-MetroGel ifana ne-generic metronidazole gel ye-BV?

Yebo. I-MetroGel-Vaginal igama lomkhiqizo we-metronidazole vaginal gel 0.75%, futhi i-Vandazole ingenye. Ama-Generics kumele afane nomkhiqizo egameni elisebenzayo, amandla, nendlela yokusebenzisa, ngakho-ke isikhathi sezinsuku ezingu-5 siyefana. Ungadidanisi umkhiqizo wesitho sangasese ne-metronidazole gel ethengiswa i-rosacea, okuyinye i-facial formulation futhi ayinakushintshaniswa nayo.

Ngaphepha ukuphuza utshwala ngenkathi ngisebenzisa i-metronidazole gel?

Cha. Imikhuba ye-CDC 2021 ithi ukugwema utshwala ngesikhathi sokwelashwa nge-metronidazole noma i-tinidazole akubalulekile, ngoba i-reaction ejwayelekile esoliswayo ayisekelwa ubufakazi obuqinisekile. Lokho kubuyisa emuva emashumini eminyaka yokwelulekwa kwe-pharmacy. Uma ukuphuza kusakwenza uzizwe ungakhululekile nge-gel, yigweme, kodwa awubeki engozini ukuxhumana okuyingozi.

Ingabe i-metronidazole gel iphephile ukuyisebenzisa ngesikhathi sokukhulelwa?

Yebo, ngezokuhweba nodokotela. I-CDC ithi i-metronidazole gel ibhekwa njengephephile ekukhulelweni, nenye inhlolovo ebonisa cishe u-70% wokwelashwa ngezinkambiso zika-Amsel futhi akukho bufakazi bemiphumela ye-teratogenic noma ye-mutagenic. Okushintsha ekukhulelweni ubunzima kunokuphepha: i-BV ihlotshaniswa nengozi yokubeletha ngaphambi kwesikhathi, ngakho-ke hlolela futhi welashwe ngokushesha esikhundleni sokuqaphela izimpawu ekhaya.

Ingabe i-metronidazole pill isusa i-BV ngokushesha kune-gel?

Cha. Indlela ye-oral iwungawu 500 mg kabili ngosuku izinsuku ezingu-7, okuyizinsuku ezimbili kune-gel yezinsuku ezingu-5, futhi amazinga okwelashwa ayefana kakhulu. I-pill ingase ibangela isicanucanu kanye nokunambitheka okuyisipesheli; i-gel igcina ukuchayeka komuthi kwasendaweni kodwa kuyavuza. Abadali imithi bavame ukukhetha ngokususelwa kwimiphumela engemihle ongathanda ukuyigwema.

Ingabe umlingani wami kufanele alashwe ukuze i-BV yami iyeke ukubuya?

Cha. I-CDC ayincomi ukwelashwa okuvamile kwabalingani ababulili besilisa, ngoba isifundazwe sesi-3 sathola ukuthi ukubaphathe akunciphisi ingozi yokubuyeka kwesifazane. Lokho kusiza kakhulu ukwazi uma ubuyekele umlingani wakho ngezizathu zokubuyeka. Ukubuyeka kuvame ukubonisa indlela i-vaginal microbiome eziphinda yakha ngayo, hhayi ukutheleleka kabusha kusuka komunye umuntu.

Isifinyezo esiqotho: i-metronidazole gel ye-BV isebenza ngokushesha endaweni ekhathaza kakhulu, nephunga livame ukuncipha ebusuku besibili, futhi lowo msebenzi ngokushesha awulona olwazisa kakhulu ngayo. Okubikezelayo ukuhlala kahle ukuqedela yonke imiyalelo emihlanu, ukusebenzisa usuku lwesithathu nosuku lwesikhombisa njengezindawo zokwenziwa kwezinqumo zangempela kunokwethemba okuyize, nokwelapha ukubuya emavikini amathathu kamuva njengokubuyeka okufanele ingxoxo entsha kunokuba kube ukwehluleka komuntu siqu.

Isitatimende: Lesi sihloko singeyezinjongo zolwazi kuphela futhi asibeki ukwelulekwa kwezokwelapha. Njalo thintana nomhlinzeki wezempilo onekhono ukuze uthole ukuxilongwa kanye nezinqumo zokwelashwa. Uma ubhekana nesimo esiphuthumayo sezokwelapha, shayela u-911 noma uye egumbini lezimo eziphuthumayo eliseduze ngokushesha.