Are there any new treatment options for recurrent bacterial vaginosis?

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Are there any new treatment options for recurrent bacterial vaginosis?

Linda Bryant

Woman with hands over crotch
There is a resurgence of interest in using intravaginal boric acid for bacterial vaginosis [Image: iStock – Voyagerix]

Recurrence of bacterial vaginosis is common and has a negative impact on quality of life, but what can be done about it? This article considers the problem and possible solutions

Key points, There have been no major advances in the treatment and cure of bacterial vaginosis, perhaps because the pathophysiology is complex, multifactorial and, Pract Green w Pale Yellow

Further reading:

  • Bradshaw C, Brotman R. Making inroads into improving treatment of bacterial vaginosis – striving for long-term cure. BMC Infect Dis 2015;15:292.
  • Jeng H, Yan T, Chen J. Treating vaginitis with probiotics in non-pregnant females: A systematic review and meta-analysis. Exp Ther Med 2020;20(4):3749–65.
  • Joseph R, Ser H, Kuai Y, et al. Finding a balance in the vaginal microbiome: How do we treat and prevent the occurrence of bacterial vaginosis? Antibiotics (Basel). 2021;10(6):719.
  • Powell A, Ghanem K, Rogers L, et al. Clinicians’ use of intravaginal boric acid maintenance therapy for recurrent vulvovaginal candidiasis and bacterial vaginosis. Sex Transm Dis 2019;46(12):810–12.
  • Reichman O, Akins R, Sobel J. Boric acid addition to suppressive antimicrobial therapy for recurrent bacterial vaginosis. Sex Transm Dis 2009;36(11):732–34.
  • Schwebke J, Carter B, Waldbaum A, et al. A phase 3, randomized, controlled trial of Astodrimer 1% Gel for preventing recurrent bacterial vaginosis. Eur J Obstet Gynecol Reprod Biol X 2021;10:100121.
  • Schwebke J, Lensing S, Lee J, et al. Treatment of male sexual partners of women with bacterial vaginosis: A randomized, double-blind, placebo-controlled trial. Clin Infect Dis 2021;73(3):e672–79.
  • Sobel J, Sobel R. Current and emerging pharmacotherapy for recurrent bacterial vaginosis. Expert Opin Pharmacother 2021;22(12):1593-1600.
  • Surapaneni S, Akins R, Sobel JD. Recurrent bacterial vaginosis: An unmet therapeutic challenge. Experience with a combination pharmacotherapy long-term suppressive regimen. Sex Transm Dis 2021;48(10):761–65.
  • van de Wijgert J, Verwijs MC. Lactobacilli-containing vaginal probiotics to cure or prevent bacterial or fungal vaginal dysbiosis: a systematic review and recommendations for future trial designs. BJOG. 2020;127(2):287–99.
  • Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep 2021;70(4):1–187.