High-Dose Vaginal Maintenance Metronidazole for Recurrent Bacterial Vaginosis: A Pilot Study

Aguin, Tina MD*; Akins, Robert A. PhD; Sobel, Jack D. MD

Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0000000000000123

Abstract: The purpose of this study was to explore the benefit of high-dose intravaginal metronidazole as a maintenance therapy in reducing recurrence rates of bacterial vaginosis (BV).

Eighteen women with a history of recurrent BV and symptomatic BV were treated with metronidazole 750 mg suppository intravaginally daily for 7 days. Those in remission by Amsel criteria received metronidazole 750 mg twice weekly for 3 months with further follow-up for 3 months. High-dose metronidazole intravaginally was associated with rare clinical recurrence during the period of use. After cessation of suppression therapy, recurrence was high.

In Brief

For women with recurrent bacterial vaginosis, using long-term suppressive high-dose vaginal metronidazole may decrease the frequency of recurrent episodes of symptomatic BV.

Author Information

From the Departments of *Obstetrics and Gynecology, †Biochemistry and Molecular Biology, and ‡Infectious Diseases, Wayne State University School of Medicine, Detroit, MI

Conflicts of interest: J.D.S. serves on the scientific advisory board of Embil Pharmaceutical. The remaining authors have no conflicts of interest to declare.

Correspondence: Jack D. Sobel, MD, Harper Hospital, 3990 John R, Room 5934, Detroit, MI 48201. E-mail: Jsobel@med.wayne.edu.

Received for publication October 2, 2013, and accepted March 3, 2014.

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