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An effective treatment for recurrent bacterial vaginosis
Women with recurrent vaginal infections often take regular, repeated doses of antimicrobials to prevent further episodes. Unfortunately, metronidazole treatment of bacterial vaginosis (BV) may lead to vulvovaginal candidiasis (VVC). In a randomised placebo-controlled trial in Kenya and the USA, HIV-negative women with either of these infections or trichomoniasis were enrolled in a study of a combined miconazole/metronidazole vaginal suppository, given for five consecutive days every month for a year.1 The intervention reduced the risk of laboratory-proven BV, the most common vaginal infection in the study, by 35%. Unfortunately, there was no effect on subsequent rates of either VVC or trichomoniasis, but it is reassuring that the treatment did not lead to an increase in VVC rates. The report does not provide a breakdown of the results according to which of the three infections was present at baseline, which would have been useful additional clinical information.
Expect the unexpected: some immunological effects of HIV
The Beijing PRIMO cohort is a large prospective study of HIV-negative men who have sex …
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