Therapy of bacterial vaginosis

Bacterial vaginosis (BV) is the commonest cause of abnormal vaginal discharge in women of childbearing age. The prevalence in the UK is between 10 and 15%. The principal symptom is an offensive fishy smell, accompanied by an increased vaginal discharge. When BV develops, the concentrations of many anaerobic or facultative anaerobic species, including Gardnerella vaginalis, Bacteroides spp. and Mycoplasma hominis, increase up to a thousand-fold, overwhelming the usually dominant lactobacilli. In the most severe forms of BV the lactobacilli disappear. The bacteria adhere to desquamated squamated squamous epithelial cells, giving them the appearance of 'clue cells'. The pH of vaginal fluid increases from the normal,