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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: May 2014 - Volume 41 - Issue 5 - p 290–291
doi: 10.1097/OLQ.0000000000000123

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.

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

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:

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

© Copyright 2014 American Sexually Transmitted Diseases Association