BACKGROUND:
Longitudinal
studies have consistently found a significant association between bacterial
vaginosis (BV) and acquisition of sexually transmitted diseases (STDs).
However, there is limited prospective data to confirm these findings.
METHODS:
We
conducted a prospective, randomized, open-label trial of home screening and
treatment of young women with asymptomatic BV who were also at high risk for
STD. These women were screened every 2 months for 12 months and randomized to
treatment with oral metronidazole 500 mg twice daily for 7 days versus
observation alone. The primary outcome was the incidence of gonorrhea and/or
chlamydia.
RESULTS:
1365
subjects were enrolled in the study across 10 sites. Adherence with mailing
specimens obtained at home was excellent in both groups (84-88%). The incidence
of gonorrhea and/or chlamydia was 19.1 per 100 person years (95% CI: 15.1-22.1)
for the treatment group and 18.5 per 100 person-years (95% CI: 15.1-22.8) for
the observation arm, a difference that was not statistically significant.
CONCLUSIONS:
Young
women were very amenable to home screening for BV, gonorrhea, and chlamydia.
Treatment of asymptomatic BV with one week of oral metronidazole did not result
in a decreased incidence of gonorrhea and/or or chlamydia.
By: Schwebke JR1, Lee JY2, Lensing S2, Philip SS3, Wiesenfeld HC4, Seña AC5, Trainor N3, Acevado N6, Saylor L6, Rompalo AM7, Cook RL8.
- 1Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
- 2Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR.
- 3San Francisco Department of Public Health, San Francisco, CA.
- 4Department of Obstetrics and Gynecology, Magee-Women's Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA.
- 5Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
- 6Family Health International, Durham, NC.
- 7Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
- 8Departments of Epidemiology and Medicine, University of Florida, Gainesville, FL.
