Researchers have shown far better cure rates for bacterial vaginosis when the condition is treated as a sexually transmitted infection.
A trial comparing antibiotic treatment for the condition for both sexual partners with the current standard care of treating the woman alone was stopped early after showing a stark difference in recurrence.
In all, 164 women took part in the study all of whom were in a monogamous relationship with a male partner. In half of them both partners were treated.
Among the control group where only the affected woman took a week-course of antibiotics 63% had recurrence within 12 weeks.
But in the group where the men also had antibiotics and a topical antimicrobial treatment to apply, 35% of the women had recurrence in the three-month follow up.
Reporting the results in the New England Journal of Medicine, the Australian researchers said previous studies looking at this had only treated male partners with oral antibiotics.
They found the results did not differ substantially according to whether the woman had an intra-uterine device – a known risk factor for bacterial vaginosis – or according to whether the male partner was circumcised.
The findings could start to change the way the condition is treated and drive down stubborn and distressing recurrence rates, the researchers concluded.
Studies have shown that more than 50% of women with bacterial vaginosis get recurrence within three months.
The study was stopped when data had been collected from 150 couples because of the effectiveness of the treating both partners.
Professor Catriona Bradshaw, a clinician researcher at Monash University and the Melbourne Sexual Health Centre, said: ‘This successful intervention is relatively cheap and short and has the potential for the first time to not only improve bacterial vaginosis cure for women, but opens up exciting new opportunities for prevention, and prevention of the serious complications associated with [it].’
Previous research has shown that men may harbour bacterial species associated with bacterial vaginosis on the penile skin and inside the penis but studies that included male partners did not show improved cure rates in their female partners.
‘This was interpreted as evidence against sexual transmission. However, these studies had design limitations, and none used a combination of oral and topical antibiotics to adequately clear bacterial vaginosis bacteria in men, especially from the penile-skin site,’ she added.
Co-author Dr Lenka Vodstrcil, a senior research fellow at Monash University, said having bacterial vaginosis was already known to increase the risk of contracting other STIs.
‘We’ve suspected for a long time that it’s a sexually transmitted infection (STI), because it has a similar incubation period (after sex) to most STIs and is associated with the same risk factors as STIs like chlamydia, such as change in sexual partner and not using condoms.’
The researchers noted it remains unclear precisely which bacteria are to blame, but advances in genomic sequencing are helping to answer that question.
In response to the trial, the Melbourne Sexual Health Centre has already changed its clinical practice to treat couples, they added.
