Partner treatment cuts bacterial vaginosis recurrence
A landmark study finds treating both women and their male partners for bacterial vaginosis dramatically reduces recurrence.
Treating women and their male sexual partners with antibiotics concurrently reduces bacterial vaginosis recurrence rates by more than 60%. The large study Gynaecology & Women’s Health, is believed to be the largest to date involving heterosexual couples receiving such combined treatment for BV.
Why some women still get BV after treatment
For about two-thirds of women, the day after they finish treatment, they return to an optimal vaginal microbiome characterised by an abundance of healthy Lactobacilli bacteria. Dr Lenka Vodstrcil, a senior research fellow at Monash University and the Melbourne Sexual Health Centre, confirmed this finding. The other third of women had microbiomes suggesting they may not have cleared their BV before couples resumed sex after treatment. These women were nearly three times more likely to get BV again within four weeks.
Factors that may affect treatment success
Persistence of infection and reinfection from partners were found to be distinct but not mutually exclusive pathways to recurrence. The study involved 188 heterosexual couples receiving concurrent treatment. Women took oral antibiotics for one week, while men were treated with both oral and topical antimicrobials.
Around 30 per cent of women in the study used an intrauterine device. The research found IUD use could enhance the persistence of BV following treatment in some women, but noted further investigation was needed. Study senior author Prof Catriona Bradshaw, head of research translation and mentorship at Monash University and the Melbourne Sexual Health Centre, highlighted the dual approach needed.
"Using partner-treatment to mitigate re-infection and more intensive strategies that target persistence of BV-bacteria, we hope to create more effective treatment approaches," Bradshaw said.
Broader context and future directions
Despite the success of partner treatment, around 20 per cent of women treated at the same time as their partners were not cured. Bacterial vaginosis affects about one in four women globally. It is characterised by a reduction of 'good' bacteria and an overgrowth of other mixed bacteria in the vagina.
BV can cause vaginal itching, burning and discomfort, although some people have no symptoms. It can increase susceptibility to other infections and is linked to complications during pregnancy and childbirth. This research builds on a landmark study from March last year which found BV can be sexually transmitted to women by male partners.
The participant group's ethnicities were representative of urban Australia. Results might not be generalisable to other global populations, including those in low-income and middle-income countries and settings with a high BV burden. Scientists plan to trial longer treatment lengths and combinations of multiple antibiotics.
