Bacterial vaginosis: a primer for clinicians

ABSTRACT

Bacterial vaginosis (BV) affects approximately one third of women in the United States. While often asymptomatic, BV infection may be accompanied by serious health consequences, such as preterm birth and pelvic inflammatory disease, and may facilitate acquisition of sexually transmitted infections. Identifying appropriate patients for screening, such as pregnant women, women planning pregnancy, and women with multiple and/or new sexual partners, is imperative for treatment. Diagnosis of BV has traditionally depended on the presence of vaginal discharge and odor, elevated pH, and clue cells as determined by microscopy, but newer diagnostic modalities that utilize molecular techniques allow for more convenient and accurate testing for BV. Approved treatment options consist of antibiotics administered as oral or intravaginal formulations. Patient counseling and education regarding treatment options, including adherence to prescribed treatments, appropriate hygienic practices, and treatment of symptomatic same-sex partners, are crucial to optimize patient outcomes and prevent recurrence.

KEYWORDS:

• Bacterial vaginosis
• clindamycin
• diagnosis
• metronidazole
• secnidazole
• tinidazole

Author contributions

The authors were responsible for all content and editorial decisions, and received no honoraria related to the development of this manuscript. Both authors contributed to the research, writing, and reviewing of all drafts of this manuscript and approved the final version.

Declaration of interest

S. Kellogg Spadt has been a consultant for Deka Development and Research Corporation, Materna, AMAG Pharmaceuticals, Inc., Ipsen, Duchesnay, TherapeuticsMD, and Lupin Pharmaceuticals, Inc. S. Reiter has been a consultant for Hologic Inc. and Lupin Pharmaceuticals, Inc./Symbiomix Therapeutics, LLC. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial relationships to disclose.

Additional information

Funding

Editorial support in preparation of this manuscript was provided by Phase Five Communications, funded by Symbiomix Therapeutics, LLC.