A 31-Year-Old Woman, Gravida 1 Para 0, at 28 Weeks

A 31-year-old woman, gravida 1 para 0, at 28 weeks gestation comes to the office for a routine prenatal visit.  The patient has had good fetal movement.  She has no abdominal pain or vaginal bleeding but reports a thin, malodorous vaginal discharge that is increasing and now requires her to use a panty liner.  The patient's pregnancy has been complicated by gestational diabetes mellitus diagnosed at 26 weeks gestation.  Due to uncontrolled glucose levels last week, an oral antihyperglycemic medication was prescribed; glucose level today shows improvement.  The patient has no other chronic medical conditions.  She exercises 3 days a week in a water aerobics class.  The patient does not use tobacco, alcohol, or illicit drugs.  She has no drug allergies.  Temperature is 37.1 C (98.8 F) , blood pressure is 120/76 mm Hg, and pulse is 74/min.  Fundal height is 28 cm.  Fetal heart rate is 150/min by Doppler ultrasonography.  Pelvic examination reveals a nontender, closed cervix without cervical discharge and a nontender gravid uterus.  A thin, gray vaginal discharge is present, but no vesicles, ulcers, or other lesions are seen.  There is no leakage of fluid through the cervix during the Valsalva maneuver.  Microscopy of the vaginal fluid shows epithelial cells that have a stippled appearance but no ferning.  Urine dipstick test is negative for protein and glucose. Item 1 of 2
Which of the following is the most appropriate management of this patient's condition?

A) Acyclovir
B) Ceftriaxone
C) Clindamycin
D) Doxycycline
E) Fluconazole