[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-401202-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-401202-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","effective-treatment-of-recurrent-bacterial-vaginosis-treatment-options","Effective treatment of recurrent bacterial vaginosis - treatment options","","Recurrent bacterial vaginosis (BV) remains challenging because initial therapy can be followed by frequent recurrence within 12 months. The editorial presents three CDC-recommended suppressive strategies and alternative options, including intermittent metronidazole vaginal gel, a boric acid lead-in followed by intermittent metronidazole, and monthly single-dose oral metronidazole plus fluconazole. Diagnostic approaches using Amsel microscopy and molecular or point-of-care tests are summarized, alongside clinician guidance on condom use and STI/HIV consideration.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/effective-treatment-of-recurrent-bacterial-vaginosis-treatment-options/401202/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/effective-treatment-of-recurrent-bacterial-vaginosis-treatment-options/401202.png","ImageObject",300,407,{"name":42,"@type":43},"AfterMidnight","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-31","2026-09-27",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"How is bacterial vaginosis diagnosed using microscopy and Amsel criteria?","Question",{"text":63,"@type":64},"BV is diagnosed when at least 3 of 4 criteria are present: homogeneous thin gray discharge, vaginal pH greater than 4.5, a positive whiff-amine test with 10% KOH, and clue cells on saline wet mount microscopy.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What is Regimen 1 for recurrent BV in the article?",{"text":68,"@type":64},"Following completion of a CDC-recommended regimen, prescribe metronidazole vaginal gel 0.75% (one full applicator) twice weekly for 6 months.",{"name":70,"@type":61,"acceptedAnswer":71},"What safety warnings are emphasized for boric acid in Regimen 2?",{"text":72,"@type":64},"The article warns that boric acid can be fatal if consumed orally, should be stored securely, and is not for use in pregnant women due to teratogenicity; poisoning may present with vomiting, fever, rash, blood count changes, metabolic acidosis, and renal failure.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},401202,1791062572,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":123,"preview_page_count":4},962090896061,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Editorial  \nEffective treatment of recurrent bacterial vaginosis  \n The 3 treatment options presented herein may help to suppress the rate of bacterial vaginosis recurrence and improve patients’symptoms as well as quality of life  \nRobert L. Barbieri, MD  \nEditor in Chief, OBG ManageMent Chair, Obstetrics and Gynecology  \nBrigham and Women’s Hospital, Boston, Massachusetts Kate Macy Ladd Professor of Obstetrics,  \nGynecology and Reproductive Biology Harvard Medical School, Boston  \nPHOTO: CDC/ M . REIN  \nacterial vaginosis (BV) is  \nBcainuvsedaginy a compl bacteriallexflo, anwigteh  \na reduction in lactobacilli (which help maintain an acidic environment) and an increase in anaerobic gramnegative organisms including Gardnerella vaginalis species and Bacteroides, Prevotella, and Mobiluncus genera. Infection with G vaginalis is thought to trigger a cascade of changes in vaginal flora that leads to BV.1  \nBV is present in 30% to 50% of sexually active women, and of these women 50% to 75% have an abnormal vaginal discharge, which is gray, thin, and homogeneous and may have a fishy odor.2 In addition to causing an abnormal vaginal discharge, BV is a cause of postpartum fever, posthysterectomy vaginal cuff cellulitis, and postabortion infection, and it increases the risk of acquiring HIV, herpes simplex type 2, gonorrhea, chlamydia, and trichomoniasis infection.3  \nWhen using microscopy and the Amsel criteria, the diagnosis of BV is made when at least 3 of the following 4 criteria are present:  \n1. homogeneous, thin, gray discharge  \nPhotomicrograph revealing clue cells (epithelial cells that have had bacteria adhere to their surface) . Clue cell presence on a saline wet mount is a sign of bacterial vaginosis.  \n2. vaginal pH >4.5  \n3. positive whiff-amine test when applying a drop of 10% KOH to a sample of the vaginal discharge  \n4. clue cells detected with microscopy on a saline wet mount.  \nIf microscopy is not available, the Affirm VPIII test (BD Diagnostic Systems, Franklin Lakes, New Jersey) for DNA sequences of G vaginalis has high sensitivity and specificity.4 The OSOM BVBlue test (Sekisui  \nDiagnostics, Lexington, Massachusetts), a Clinical Laboratory Improvement Amendments–waived point of service test, measures vaginal sialidase, which is produced by Gardnerella and other pathogens associated with BV.5 BV may be detected in routine cervical cytology testing and, if the patient is symptomatic, treatment is recommended.  \nInitial treatment of BV. The Centers for Disease Control and Prevention CONTINUED ON PAGE 8  \n[o bgmanagement. com](o bgmanagement. com) Vol. 29 No . 7 | July 2017 | OBG Management 7  \nCONTINUED FROM PAGE 7  \n(CDC) has recommended 3 treatment regimens for BV and 4 alternative treatment options (TABLE, page 11).6 In addition to antimicrobial treatment, the CDC recommends that women with BV use condoms with sexual intercourse. The CDC also advises that clinicians should consider testing women with BV for HIV and other sexually transmitted infections.  \nTreatment of recurrent BV  \nA major problem with BV is that, although initial treatment is successful in about 80% of cases, up to 50% of women will have a recurrence of BV within 12 months of initial  \ntreatment.2 Preliminary studies suggest that for women with 3 or more episodes of BV, the regimens below may be effective.  \nRegimen 1  \nFollowing the completion of a CDCrecommended treatment regimen (see TABLE), prescribe metronidazole vaginal gel 0.75%, one full applicator, twice weekly for 6 months.7  \nIn a prospective randomized trial examining this regimen, following initial treatment with a 10-day metronidazole vaginal gel regimen 112 women were randomly assigned to chronic suppressive therapy with metronidazole vaginal gel 0.75%, one full applicator, twice weekly for  \nInstant Poll  \nIn your practice do you prefer 1 of the following options for the treatment of recurrent BV?  \nA) Regimen 1: Intermittent vaginal metronidazole treatment.  \nFollowing the comp","cbCaijf15LZnU73U","https://ap.wps.com/l/cbCaijf15LZnU73U","pdf",118943,"English","# Effective treatment of recurrent bacterial vaginosis\n## Diagnostic approach for bacterial vaginosis\n## Treatment of recurrent BV\n## Regimen 1: intermittent vaginal metronidazole\n## Regimen 2: boric acid followed by intermittent metronidazole\n## Regimen 3: monthly single-dose oral metronidazole plus fluconazole\n## Patient poll and practice preferences","[{\"question\":\"How is bacterial vaginosis diagnosed using microscopy and Amsel criteria?\",\"answer\":\"BV is diagnosed when at least 3 of 4 criteria are present: homogeneous thin gray discharge, vaginal pH greater than 4.5, a positive whiff-amine test with 10% KOH, and clue cells on saline wet mount microscopy.\"},{\"question\":\"What is Regimen 1 for recurrent BV in the article?\",\"answer\":\"Following completion of a CDC-recommended regimen, prescribe metronidazole vaginal gel 0.75% (one full applicator) twice weekly for 6 months.\"},{\"question\":\"What safety warnings are emphasized for boric acid in Regimen 2?\",\"answer\":\"The article warns that boric acid can be fatal if consumed orally, should be stored securely, and is not for use in pregnant women due to teratogenicity; poisoning may present with vomiting, fever, rash, blood count changes, metabolic acidosis, and renal failure.\"}]","Effective treatment of recurrent bacterial vaginosis - treatment options | PDF",1790517607]