Background Bacterial vaginosis is the commonest cause of abnormal vaginal
discharge in women of reproductive age and is associated with
serious pregnancy related sequelae and increased transmission
of sexually transmissible infections, including HIV. The aetiology,
pathology, microbiology and transmission of bacterial vaginosis
remain poorly understood.
Objective This article discusses the prevalence, clinical features and
possible complications of bacterial vaginosis. It summarises
what is known about the aetiology, pathophysiology and
treatment of the condition and highlights directions for further
Discussion Bacterial vaginosis is characterised by a complex disturbance
of the normal vaginal flora with an overgrowth of anaerobic
and other micro-organisms and a corresponding decrease
in important lactobacillus species. The cause is not known,
but observational evidence suggests the possibility of sexual
transmission. Bacterial vaginosis is diagnosed by the Amsel
or the Nugent method. Recommended treatment is with 7 days
of oral metronidazole or vaginal clindamycin. More than 50%
of women will experience recurrence of bacterial vaginosis
within 6 months. It is not known whether this represents relapse
or re-infection. Further research is needed into the aetiology,
pathogenesis and optimal treatment of this condition.
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