Clindamycin for BV: what it does and when doctors use it

Bacterial vaginosis (BV) is common and often comes back — roughly 30% of people get BV again within a few months. Clindamycin is one of the antibiotics doctors use to treat it. It kills the bacteria that cause the smell, discharge, and irritation, and it comes as a vaginal cream/ovule or an oral pill. Which one you get depends on your symptoms, history, and whether you can take certain medicines.

How to use clindamycin for BV

Topical option: clindamycin vaginal cream (usually 2%) is a common choice. Typical use is one applicator (about 5 g) inserted into the vagina at bedtime for 7 days. The cream works locally and often causes fewer stomach issues than pills.

Oral option: clindamycin capsules are often prescribed as 300 mg twice a day for 7 days for BV. Doctors pick the oral route when an infection is more widespread or if topical treatment failed before.

Quick tips for both forms: finish the full course even if you feel better after a few days. Don’t douche during treatment — it reduces effectiveness and can worsen recurrence. Use the cream at night so it stays in place. If you use tampons, switch to pads during treatment to avoid removing the medicine.

Side effects, risks, and when to call your doctor

Common side effects: local burning or itching (with the cream), mild stomach upset, and diarrhea (with pills). A rarer but serious risk with clindamycin is Clostridioides difficile (C. difficile) infection which causes severe, persistent diarrhea and requires urgent care. If you get many watery stools, fever, or belly pain, stop the drug and contact a clinician right away.

Yeast overgrowth: antibiotics can let yeast grow, so you might get a yeast infection after treating BV. If you develop thick white discharge and itching after finishing clindamycin, you may need antifungal treatment.

Pregnancy and breastfeeding: vaginal clindamycin is commonly used in pregnancy and is generally considered safe, but always check with your OB or midwife. Clindamycin passes into breast milk in small amounts; mention breastfeeding so your clinician can advise on risks and monitoring.

Other practical notes: clindamycin doesn’t have the alcohol warning that metronidazole does, but it can interact with some other medicines — give your provider a full list of drugs and supplements. BV often recurs; if symptoms return within a couple of months, follow up. Your clinician might try a different antibiotic, a longer course, or additional strategies like partner counseling or symptom monitoring.

If you’re unsure whether you have BV or another vaginal condition, get tested. Self-treatment without a diagnosis can miss yeast infections, STIs, or other issues. Ask your provider about follow-up if symptoms persist beyond a week after treatment ends.

Want straightforward help? Ask your clinician these three questions: which form of clindamycin is best for me, what side effects should I watch for, and when should I come back if symptoms don’t clear? That will keep treatment simple and effective.