Bacterial Vaginosis

Polymicrobial, nonspecific vaginitis associated with positive cultures of Gardnerella vaginalis and other anaerobic organisms and a decrease in lactobacilli. It remains unclear whether the initial pathogenic event is caused by the growth of anaerobes or a primary decrease in lactobacilli.

Also Known As:

Networked: 1593 relevant articles (162 outcomes, 318 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Infections
2.	Trichomonas Infections
3.	Premature Birth (Birth, Premature)
4.	Vaginitis
5.	Vulvovaginal Candidiasis

Experts

1.	Hillier, Sharon L: 36 articles (01/2022 - 10/2002)
2.	Schwebke, Jane R: 24 articles (01/2022 - 04/2004)
3.	Sobel, Jack D: 24 articles (12/2021 - 07/2002)
4.	Reid, Gregor: 18 articles (01/2018 - 01/2004)
5.	Klebanoff, Mark A: 16 articles (01/2019 - 06/2003)
6.	Brotman, Rebecca M: 15 articles (05/2022 - 10/2006)
7.	Fredricks, David N: 15 articles (12/2021 - 11/2005)
8.	Meyn, Leslie A: 14 articles (01/2022 - 03/2003)
9.	Ravel, Jacques: 13 articles (09/2022 - 03/2011)
10.	Vaneechoutte, Mario: 13 articles (01/2022 - 04/2004)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Bacterial Vaginosis:

1.	Metronidazole (Metric)FDA LinkGeneric 07/01/2000 - "Most patients with odor had bacterial vaginosis and had an improvement in odor with topical metronidazole. " 04/01/1999 - "The most cost-effective treatment for bacterial vaginosis was generic metronidazole. " 07/01/1990 - "Metronidazole (500 mg twice daily for 7 days) continues to be highly efficacious in the treatment of bacterial vaginosis. " 03/01/2023 - "Thus, recently, a phase 2b trial using a Lactobacillus crispatus strain as a therapeutic add-on to standard metronidazole showed significant reduction in the recurrence of bacterial vaginosis by 12 weeks compared to placebo. " 01/01/2020 - "Metronidazole is the first-line treatment for bacterial vaginosis, but cure rates are suboptimal and recurrence rates high. "
2.	Clindamycin (Cleocin)FDA LinkGeneric 01/01/2022 - "Single-Dose Clindamycin Gel Highly Effective for Bacterial Vaginosis." 08/01/1995 - "Of the 80 patients who were recorded "success" or "improved" at visit 2, 20 (25%) were reported to have a "recurrence" of BV at Visit 3. The meta-analysis on those who were evaluable at Visit 2 and 3 also showed that clindamycin cream 2% was an effective treatment for bacterial vaginosis, and the differences between the clindamycin group and the placebo group were statistically significant. " 11/01/1994 - "Clindamycin eradicated and/or decreased counts of major bacterial vaginosis-associated microflora such as Gardnerella, gram-negative and gram-positive anaerobes, and Mycoplasma hominis; this was correlated with cure in 22 of 24 (92%) women. " 08/01/1995 - "We conclude that a 3 day course of clindamycin 2% cream is an effective, and well tolerated treatment for bacterial vaginosis." 11/01/1994 - "Microbial (and clinical) results support use of clindamycin as effective treatment of bacterial vaginosis."
3.	Vaginal Creams, Foams, and Jellies (Vaginal Tablet)IBA 10/01/2020 - "mirifica vaginal gel in postmenopausal women with GSM has been proved to be effective in reducing indicators of bacterial vaginosis compared with placebo gel. " 06/01/2005 - "We evaluated the efficacy of a mucoadhesive vaginal gel (MVG, Miphil) with acidic-buffering properties in bacterial vaginosis (BV). " 04/01/2023 - "Prevention of recurrence of bacterial vaginosis using lactobacilli-containing vaginal tablets among women with HIV: a randomized, placebo-controlled, double-blinded phase IV trial." 04/01/2018 - "This trial showed that Prangos ferulacea vaginal cream accelerated the recovery of bacterial vaginosis of patients with bacterial vaginosis. " 04/01/2018 - "The present study was conducted on the effect of prangos ferulacea vaginal cream on accelerating the recovery of bacterial vaginosis. "
4.	Coloring Agents (Dyes)IBA 04/01/2004 - "No significant differences were noted when comparing drug and placebo in terms of subjective or clinical improvement or improvement in Gram stain smears for bacterial vaginosis. " 01/01/1998 - "The purpose of the study is to determine whether the Gram stain method is superior to the clinical criteria for the diagnosis of bacterial vaginosis in low-income pregnant women seen in a resident clinic setting. " 09/01/2001 - "The aim of this study was to determine the accuracy of a wet-mount bacterial morphology scoring (BMS) system and Nugent's Gram stain analysis for the diagnosis of bacterial vaginosis, using Amsel's criteria as the gold standard. " 11/01/2005 - "To compare the sensitivity of BVBLUE test for diagnosis of bacterial vaginosis with Gram stain by using Nugent score as a gold standard. " 03/01/2005 - "All 4 clinical criteria for diagnosing bacterial vaginosis were collected, and Gram stain was used as the gold standard. "
5.	TinidazoleFDA Link 08/01/2007 - "Both tinidazole regimens studied provided effective treatment for bacterial vaginosis. " 02/01/2009 - "Improved cure of bacterial vaginosis with single dose of tinidazole (2 g), Lactobacillus rhamnosus GR-1, and Lactobacillus reuteri RC-14: a randomized, double-blind, placebo-controlled trial." 10/01/1993 - "A randomized double-blind trial of tinidazole treatment of the sexual partners of females with bacterial vaginosis." 08/09/2010 - "Oral tinidazole has been used to treat bacterial vaginosis for over 25 years but in a number of different dosage regimens. " 08/09/2010 - "Tinidazole in the treatment of bacterial vaginosis."
6.	Lactic Acid (Lactate)FDA LinkGeneric 03/01/2023 - "Studies examining the metabolites produced by polymicrobial bacterial vaginosis (BV) states and Lactobacillus-dominated microbiota have noted a dramatic reduction of lactic acid and a shift toward SCFA synthesis. " 01/01/2021 - "The vaginal microbiota in bacterial vaginosis (BV) typically has low abundance of lactic acid producing lactobacilli. " 01/01/2021 - "Lactic acid-containing products for bacterial vaginosis and their impact on the vaginal microbiota: A systematic review." 09/01/2016 - "Diversity of Vaginal Lactic Acid Bacterial Microbiota in 15 Algerian Pregnant Women with and without Bacterial Vaginosis by using Culture Independent Method." 01/01/2016 - "Based on recent insights in community ecology of the vaginal microbiome, we hypothesize that sustained vaginal DL-lactic acid enrichment will enhance the recruitment of lactobacilli, while counteracting bacterial vaginosis-associated bacteria. "
7.	secnidazoleIBA 03/01/2005 - "To determine whether bacterial vaginosis could be cured with a single 1-g oral dose of secnidazole. " 01/01/2018 - "A Phase 3, Multicenter, Prospective, Open-Label Study to Evaluate the Safety of a Single Dose of Secnidazole 2 g for the Treatment of Women and Postmenarchal Adolescent Girls with Bacterial Vaginosis." 12/01/2017 - "Based on the investigator's clinical assessment at the test of cure/end of study visit, significantly more patients receiving single-dose secnidazole 2 g vs placebo required no additional bacterial vaginosis treatment (68.0% [68/100] vs 29.6% [16/54]; P < .001). " 12/01/2017 - "A phase-3, double-blind, placebo-controlled study of the effectiveness and safety of single oral doses of secnidazole 2 g for the treatment of women with bacterial vaginosis." 01/01/2017 - "To evaluate secnidazole as a single oral dose treatment for bacterial vaginosis in a phase 2 randomized, double-blind, placebo-controlled study. "
8.	Erythromycin (Erycette)FDA LinkGeneric 11/01/1979 - "To assess the efficacy of oral erythromycin in the treatment of nonspecific vaginitis (NSV), conducted a nonrandom, unblinded pilot study among 17 women with symptoms and signs of NSV. " 07/01/1996 - "Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis." 12/28/1995 - "Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis." 09/01/1998 - "Two trials with use of metronidazole (alone or with erythromycin) showed a reduction in preterm delivery in women who were at a high risk of preterm delivery and had bacterial vaginosis at screening. " 12/28/1995 - "Treatment with metronidazole and erythromycin reduced rates of premature delivery in women with bacterial vaginosis and an increased risk for preterm delivery."
9.	Anti-Bacterial Agents (Antibiotics)IBA 01/01/2023 - "Antibiotics provide a short-term cure for bacterial vaginosis; however, fail to provide a consistent long-term cure for many women. " 10/01/2008 - "To evaluate the efficacy of additional topical Lactobacillus casei rhamnosus (Lcr35) subsequent to antibiotic treatment of bacterial vaginosis (BV) to restore the normal vaginal flora. " 10/01/2020 - "Finally, a total of 30 studies on bacterial vaginosis (BV) and/or VVC were included and stratified into 3 study types based on treatment design as follows: Type I, antibiotic/probiotics vs. antibiotics/antifungals (22 studies); Type II, probiotics vs. placebo (5 studies); Type III, probiotics vs. antibiotics (3 studies). " 01/31/2013 - "Randomised trials comparing antibiotic treatment with placebo or no treatment, or comparing two or more antibiotic regimens in pregnant women with bacterial vaginosis or intermediate vaginal flora whether symptomatic or asymptomatic and detected through screening. " 08/19/2011 - "The primary objective of this study was to investigate if extended antibiotic treatment against bacterial vaginosis (BV) together with adjuvant lactobacilli treatment could cure BV and, furthermore, to investigate factors that could cause relapse. "
10.	astodrimerIBA 07/01/2021 - "Astodrimer gel is effective in treating bacterial vaginosis and corroborated by clinical (Amsel criteria) and microbiological (Nugent score) measurements as well as patient-reported symptoms. " 02/01/2020 - "These results support a role for Astodrimer 1 % Gel as an effective, safe and well-tolerated treatment for women with bacterial vaginosis." 01/01/2020 - "These results support a role for Astodrimer Gel, 1%, as an effective treatment for bacterial vaginosis." 07/01/2021 - "We attempted to conduct a systematic review and meta-analysis of all randomized controlled trials (RCTs) which examined the efficacy and safety of astodrimer gel in patients with bacterial vaginosis. " 07/01/2021 - "Astodrimer gel for treatment of bacterial vaginosis: A systematic review and meta-analysis of randomized controlled trials."

Therapies and Procedures

1.	Therapeutics 02/01/2004 - "Women who underwent placebo therapy had significant remission of bacterial vaginosis over > or =10 weeks. " 01/01/1993 - "The results demonstrate a high efficacy of eubiotic therapy of bacterial vaginosis." 01/31/2013 - " therapy was shown to be effective at eradicating bacterial vaginosis during pregnancy (average risk ratio (RR) 0.42; 95% confidence interval (CI) 0.31 to 0.56; 10 trials, 4403 women; random-effects, T² = 0.19, I² = 91%). " 12/01/2019 - "This systematic review and meta-analysis systematically evaluated the efficacy of probiotic monotherapy and combination therapy for bacterial vaginosis (BV). " 09/01/1991 - "The diagnostic category of nonspecific vaginitis is not helpful in therapy or in prevention and should be abandoned. "
2.	Condoms (Condom) 11/01/2007 - "When we excluded women with intermediate flora, consistent condom use was even more strongly protective against bacterial vaginosis (0.37 [0.20-0.70]). " 11/01/2007 - "Previous studies have been inconsistent with regard to whether condom use is associated with bacterial vaginosis. " 05/01/2023 - "Changing partners in the last 3-months (2.09 [95% CI 1.14‒3.82]; p = 0.017), inconsistent use of condoms (2.61 [95% CI 1.10‒6.20]; p = 0.030) and positive diagnosis of Chlamydia trachomatis (2.40 [95% CI 1.01‒5.73]; p = 0.048) were associated with bacterial vaginoses only in WSH. " 01/01/2019 - "We tested bacterial vaginosis (measured by Nugent Score) and sexual behaviors (condom use, number of partners, and partner concurrence) as mediators using VanderWeele's difference method. " 01/01/2013 - "Consistent condom use increases the colonization of Lactobacillus crispatus in the vagina and may protect against both bacterial vaginosis (BV) and human immunodeficiency virus (HIV)."
3.	Aftercare (After-Treatment) 10/01/2004 - "This study was undertaken to evaluate antimicrobial susceptibility of vaginal anaerobic bacteria before and after treatment of bacterial vaginosis. " 04/01/1998 - "Included in this study, which spanned the period from January 1988 to June 1996, were all patients who were referred by their gynecologists for continuing vulvovaginal symptoms after treatment for bacterial vaginosis. " 01/01/1997 - "The cure rate after treatment of bacterial vaginosis (BV) differs in various investigations, but most studies report a cure rate of 70% after 1 month. " 01/01/2019 - "Many diagnostic tests are available that differentiate bacterial vaginosis from other types of vaginal disorders, but none predict recurrence after treatment, nor are any vetted for monitoring ongoing responses to treatment. " 01/01/2018 - "Then, patients were assessed for bacterial vaginosis on 90 ± 3 day after treatment. "
4.	Intravaginal Administration 07/01/2008 - "Safe and effective long-term vaginal administration of Lactobacillus rhamnosus appears to be a useful complementary approach in the management of bacterial vaginosis." 09/01/2010 - "Long-term vaginal administration of Lactobacillus rhamnosus as a complementary approach to management of bacterial vaginosis." 10/07/2009 - "The dominance of lactobacilli in healthy vaginal microbiota and its depletion in bacterial vaginosis (BV) has given rise to the concept of oral or vaginal instillation of probiotic Lactobacillus strains for the management of this condition. " 01/01/2009 - "The data indicate that intravaginal administration of exogenous selected strains of lactobacilli can restore a normal vaginal microbiota and be used in treating bacterial vaginosis." 09/01/2010 - "In summary, five days of vaginal administration of LN strains after conventional treatment of bacterial vaginosis and/or vulvovaginal candidiasis lead to vaginal colonization, somewhat fewer recurrences and less malodorous discharge."
5.	Complementary Therapies (Alternative Medicine) 09/01/2019 - "The purpose of this article is to review the state of the science regarding the safety and efficacy of alternative therapies for the treatment of bacterial vaginosis in nonpregnant women." 09/01/2019 - "Bacterial Vaginosis: A Clinical Update with a Focus on Complementary and Alternative Therapies." 09/01/2005 - "Alternative therapies for bacterial vaginosis: a literature review and acceptability survey." 05/01/2003 - "Common complementary and alternative therapies for yeast vaginitis and bacterial vaginosis: a systematic review." 05/01/2003 - "This article is a systematic review of the literature regarding the most commonly used complementary and alternative medicine (CAM) therapies for yeast vaginitis and bacterial vaginosis. "