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Treating bacterial vaginosis prevents STD

Treating silent or asymptomatic bacterial vaginosis with metronidazole gel may help prevent women from acquiring chlamydia infection.

Treating bacterial vaginosis prevents STD

Treating silent or asymptomatic bacterial vaginosis with metronidazole gel may help prevent women from acquiring chlamydia infection—a sexually transmitted disease (STD). Bacterial vaginosis is the most common type of vaginal infection in pregnant women, which occurs when there is imbalance in the bacteria of the vagina favouring certain "bad" microbes over "good" ones (lactobacilli, which form the normal flora of the vagina). The infection may be accompanied by a foul-smelling vaginal discharge, pain, itching or burning. Nearly half the women with bacterial vaginosis report no signs or symptoms at all. In such cases, the patient needs to be clinically examined for signs of bacterial vaginosis and lab tests need to be performed on a sample of vaginal fluid to look for bacteria associated with the infection. Bacterial vaginosis has been linked with an increased risk of STD/HIV acquisition in cross-sectional studies. Chlamydia trachomatis infection most commonly affects the urogenital tract, and most women with chlamydial infection have minimal or no symptoms, but some may develop pelvic inflammatory disease. The treatment of bacterial vaginosis, without any symptoms, with metronidazole could decrease rates of chlamydia infection. To substantiate this, researchers from the University of Alabama at Birmingham School of Medicine randomly assigned 107 women found to have asymptomatic bacterial vaginosis to an observation group or to treatment with local application of metronidazole gel daily for 5 days followed by twice weekly for 6 months. The women were screened for STD at monthly intervals. After 6 months, it was found that chlamydia infection was much lower in the metronidazole group than in the observation only group. Although bacterial vaginosis may clear up without treatment, it is recommended that all women with symptoms be treated with antibiotics to avoid complications. This is especially relevant since chlamydia infections have increased in importance and the Centers for Disease Control and Prevention (CDC) has recently recommended annual screening for chlamydial infection in all sexually active women 24 years and younger and in women older than 24 years who are at risk of STDs (e.g., have a new sex partner or have a history of multiple sex partners).
American Journal of Obstetrics and Gynecology,
June 2007
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