Metronidazole for Bacterial Vaginosis: A Comparison of Vaginal Gel vs. Oral Therapy

Bacterial Vaginosis and Susceptibility to HIV Infection in South African Women: A Nested Case‐Control Study

“…The high prevalence of BV in our study population means that almost one-third of all new HIV infections in women in this setting might be prevented if all cases of BV could be cured (i.e., a populationattributable fraction of 31% [35]), paralleling previous estimates [17]. However, it is important to note that treatment of BV can be difficult, because treatment with metronidazole may fail in up to 50% of all cases, and recurrence even after successful treatment is common [36,37]. In our study, there did not appear to be any attenuation of the association between BV and HIV seroconversion in women who were treated with at Virginia Tech on March 14, 2015 http://jid.oxfordjournals.org/ Downloaded from metronidazole at enrollment.…”

“…Follow-up visits at 24 and 36 months after enrollment were still being conducted when this nested case-control study was undertaken. For comparison, control subjects were selected at random from the cohort (n p 324) of women who had not seroconverted by the visit at which the index case patient had seroconverted (i.e., incidence-density sampling was used) and were frequency matched to case patients by age category (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), or 50-65 years old) to facilitate statistical adjustment for age [22,23].…”

Changes in the Vaginal Microenvironment with Metronidazole Treatment for Bacterial Vaginosis in Early Pregnancy

“…No difference between the oral and vaginal metronidazole treatment groups was seen in terms of cure rates or pregnancy outcomes, and both groups had preterm delivery rates of approximately 12%, in keeping with past studies. 3,30,31 Microbiological and therapeutic cures were associated with a significant decrease in the vaginal concentrations of the proinflammatory cytokine IL-1b but not IL-6 or IL-8. Women who did not meet criteria for cure did not show any decrease in vaginal cytokine concentrations.…”

European (IUSTI/WHO) guideline on the management of vaginal discharge, 2011

“…Furthermore, patients receiving vaginal metronidazole gel suffered from vulvovaginal candidosis more often than placebo users (P ¼ 0.02). 103 Studies have found that the adjuvant vaginal application of probiotics was effective in preventing recurrences of BV over a six-month period. In one study, twice daily oral metronidazole was compared with a regimen of daily intravaginal application of lactobacilli, showing similar results after four weeks and fewer failures at three months.…”