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: Jsobel@med.wayne.edu.
Received for publication October 2, 2013, and accepted March 3, 2014.