Should male consorts of women with bacterial vaginosis be treated?

Moi, Harald; Erkkola, R; Jerve, F; Nelleman, G; Bymose, B; Alaksen, K; Tornqvist, Ewa Wigaeus

doi:10.1136/sti.65.4.263

Cited by 49 publications

(46 citation statements)

References 17 publications

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“…On the other hand, the treatment of male sexual consorts of women with bacterial vaginosis did not significantly reduce the recurrence rates of vaginosis reported in two large studies (146,237).…”

Section: Transmission Of Bacteria Associated With Vaginosismentioning

confidence: 99%

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Gardnerella vaginalis: characteristics, clinical considerations, and controversies

1992

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The clinical significance, Gram stain reaction, and genus affiliation of Gardnerella vaginalis have been controversial since Gardner and Dukes described the organism as the cause of "nonspecific vaginitis," a common disease of women which is now called bacterial vaginosis. The organism was named G. vaginalis when taxonomic studies showed that it was unrelated to bacteria in various genera including Haemophilus and Corynebacterium. Electron microscopy and chemical analyses have elucidated the organism's gram-variable reaction. Controversy over the etiology of bacterial vaginosis was largely resolved by (i) studies using improved media and methods for the isolation and identification of bacteria in vaginal fluids and (ii) standardization of criteria for clinical and laboratory diagnosis. Besides G. vaginalis, Mobiluncus spp., Mycoplasma hominis, and certain obligate anaerobes are now acknowledged as participants in bacterial vaginosis. The finding that G. vaginalis, Mobiluncus spp., and M. hominis inhabit the rectum indicates a potential source of autoinfection in addition to sexual transmission. Extravaginal infections with G. vaginalis are increasingly recognized, especially when the toxic anticoagulant polyanetholesulfonate is omitted from blood cultures and when urine cultures are incubated anaerobically for 48 h. The finding that mares harbor G. vaginalis suggests that an equine model can be developed for studies of Gardnerella pathogenesis.

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Section: Transmission Of Bacteria Associated With Vaginosismentioning

confidence: 99%

“…Metronidazole is commonly used and gives initial cure rates of approximately 90% or better (8,17,79,108,146,167,170,226,237). Metronidazole becomes widely distributed in the body and undergoes oxidative metabolism in the liver, with the formation of several metabolites (132).…”

Section: Susceptibility To Chemotherapeutic Agentsmentioning

confidence: 99%

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

1992

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“…63,93 Topical sulfonamide creams have been used for many years in the therapy of bacterial vaginosis, but there are no data to support their use. Two randomized, doubleblind trials have not shown a benefit from treating the sexual partner, 94,95 and this is not recommended.…”

Section: Treatmentmentioning

confidence: 99%

Evaluation and management of vaginitis

1998

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V aginitis is a common medical problem in women that is associated with substantial discomfort and frequent medical visits. Roughly 5 to 10 million office visits per year are attributed to vaginitis. 1 Research in recent years has increased our understanding of the disease process and its potential sequelae and resulted in improved diagnostic and treatment modalities. 2-6 Nevertheless, adequate diagnosis and treatment of vaginitis in the office setting often is problematic for practitioners. 2,5,7-9 Moreover, the availability of over-the-counter medications for fungal vaginitis has increased the likelihood that women will come to medical attention with partially or inadequately treated infections. 10 We will focus on the common infectious causes of vaginal discharge-yeast infection, bacterial vaginosis, and trichomonas infection, emphasizing new developments in diagnosis, associated complications, and treatment of these infections.The initial evaluation of vaginal discharge requires an understanding of physiologic vaginal discharge and what differentiates it from abnormal, pathologic discharge. Substances from the vulvar, sebaceous, sweat, Bartholin's and Skene's glands, as well as exfoliated cells, cervical mucus, and secretions of the endometrial cavity and fallopian tubes constitute the normal physiologic secretions of the vagina. These secretions pool in the posterior fornix and do not adhere to the vaginal walls. 11 The pH of normal vaginal secretions in women of childbearing age is between 3.8 and 4.5. The presence of sperm, blood, amniotic fluid, or cervical mucus raises the vaginal pH. 11 The amount and fluidity of the discharge can vary over the menstrual cycle. Cervical mucus becomes more fluid around ovulation, and women frequently mistake this change in consistency for an abnormal discharge. Stress increases the rate of vaginal desquamation and thus the amount of discharge, which patients can also mistake for a pathologic discharge. 12 Women generally do not have other symptoms if their discharge is physiologic.In contrast, a pathologic discharge adheres to the vaginal walls and is often accompanied by irritation, pruritus, odor, or urinary symptoms such as dysuria or frequency. 6 The discharge can be thick to watery and frothy, and white to yellow, gray, or green. 11 Causes of an abnormal discharge include infectious causes of vaginitis such as yeast infection, bacterial vaginosis, and trichomonas infection, as well as cervicitis and sexually transmitted diseases such as gonorrhea and chlamydia infection. Noninfectious etiologies include chemical irritants such

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“…Cure and recurrence rates were similar among women with treated partners (cure: 51/54 and recurrence: 13/54) or placebo partners (cure: 44/53 and recurrence: 14/53) ( Table 1). Moi et al (1989) (4) in another double-blind randomized controlled trial with 241 women who were treated with 2 g of metronidazole, and repeated 2 days later. The partners were randomly treated with the same dose of metronidazole.…”

Section: Bacterial Vaginosismentioning

confidence: 99%

“…However several questions are debatable, such as best drug to be used, treatment regiment and most appropriate route of administration. Since VT has been confirmed as a sexually transmitted disease (STD), the treatment of an asymptomatic partner is uncontested (3)(4)(5) . Some studies suggest that treatment of sexual partners of women with BV could reduce recurrence rates from 5% to 20%.…”

Section: Introductionmentioning

confidence: 99%

VulVoVaginitis and the treatment of asymptomatic partners: a systematic reView and metanalisis

Giraldo¹,

Rodrigues²,

Melo³

et al. 2013

J bra doenças sex transm

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Introduction: treating sexual partners of women with vaginal candidiasis and bacterial vaginosis is an issue in debate. Despite the present recommendations of the international guidelines to not to treat the asymptomatic sexual partners, this is a frequent practice between gynecologists. Objective: evaluate the influence of treating asymptomatic sexual partner of women with recurrent vulvovaginitis. Methods: databases searched: PubMed, Embase, Scielo and CINAHAL. Selection criteria: randomized clinical trials published from 1982 to 2012 were included. Studies involving pregnant women were excluded. Methodological quality was assessed using the Jadad scale. Data collection and analysis: Review Manager 5.1 was used for statistical analysis. Results: eight randomized clinical trials were included based on the chosen criteria: 1,088 women were enrolled. For bacterial vaginosis, the RR for cure was 1.00 (95%CI: 0.95-1.05) (p = 0.13), and for recurrence 0.84 (95%CI: 0.62-1.14) (p = 0.34). Vaginal candidiasis had a RR of 1.03 (95%CI: 0.94-1.14) (p = 0.48) for cure, and 1.02 (95%CI: 0.77-1.33 p = 0.91) for recurrence. Conclusion: treatment of asymptomatic sexual partners of women with vaginal candidiasis or bacterial vaginosis does not affect the cure or recurrence rates and may increase the risk of side effects and unnecessary financial costs.

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Should male consorts of women with bacterial vaginosis be treated?

Cited by 49 publications

References 17 publications

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

Evaluation and management of vaginitis

VulVoVaginitis and the treatment of asymptomatic partners: a systematic reView and metanalisis

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