treatment for a vaginal discharge

R.S. is a 32-year-old woman who seeks treatment for a vaginal discharge that she has had for the past month. She is sexually active and has had the same partner for the past 6 months. She reports noticing an odor, especially after sexual intercourse. Her history reveals that she has been using a commercial douche on a biweekly basis during the past year for hygienic purposes in an attempt to prevent vaginal infections. She denies any other associated symptoms. The physical examination reveals a white vaginal discharge. Microscopic examination of the vaginal discharge shows clue cells, and the pH is 5.5.

Diagnosis: Bacterial Vaginosis 

1. List specific goals of treatment for this patient.

2. What drug therapy would you prescribe? Why?

3. Discuss specific patient education based on the prescribed therapy.

4. List one or two adverse reactions for the selected agent that would cause you to change therapy.

5. What OTC or alternative medications would be appropriate for this patient?

6.What dietary or lifestyle changes should be recommended?