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Recurrent bacterial vaginosis

Hay, Phillip

Current Opinion in Infectious Diseases: February 2009 - Volume 22 - Issue 1 - p 82–86
doi: 10.1097/QCO.0b013e32832180c6
Sexually transmitted diseases and urinary tract infections: Edited by Anton L. Pozniak

Purpose of review Bacterial vaginosis is a common condition that recurs frequently, adversely affecting women's lives, and is associated with complications including increased risk of sexually transmitted infections, HIV, and adverse pregnancy outcome.

Recent findings New molecular techniques have increased our understanding of the numerous bacteria associated with bacterial vaginosis, and a biofilm containing mostly Gardnerella and Atopobium vaginae, which can persist after treatment has been described. Suppressive treatment with metronidazole gel can suppress recurrence. Physiological approaches such as acidification and probiotics have been investigated with variable results.

Summary Advances in our understanding of the pathogenesis of bacterial vaginosis allow the opportunity to improve treatments to prevent recurrence, which may require a combination of modalities. We must find ways to help affected women and reduce the complications associated with bacterial vaginosis.

Centre for Infection, St George's Hospital, University of London, London, UK

Correspondence to Dr Phillip Hay, Reader and Honorary Consultant in Genitourinary and HIV Medicine, Courtyard Clinic, St George's Hospital, Blackshaw Road, SW17 0QT London, UK Tel: +44 2087253355; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.