Interrelationships of Bacterial Vaginosis and Cervical Inflammation

Sex Transm Dis. 2002 Jan;29(1):59-64. doi: 10.1097/00007435-200201000-00010.

Abstract

Background: Women with cervicitis frequently have bacterial vaginosis (BV). Prior studies have suggested that BV is involved in the pathogenesis of cervicitis.

Goals: To delineate the association of BV and cervicitis and to determine whether treatment of BV results in increased resolution of cervicitis.

Study design: Women with clinically diagnosed cervicitis and BV received doxycycline and ofloxacin and were randomized to treatment with metronidazole gel or placebo. Resolution of BV and cervicitis was assessed.

Results: Metronidazole gel was associated with resolution of BV. Resolution of cervicitis was associated with use of metronidazole gel versus placebo (24/27 [88.9%] versus 15/24 [62.5%]; P = 0.03). When further stratified by resolution of BV, those whose BV resolved were more likely to have resolution of cervicitis than those with persistent BV. Although these trends persisted in multivariate analyses, they did not achieve statistical significance.

Conclusion: Univariate analyses suggest an association between BV and cervicitis. An association between the use of metronidazole gel and resolution of cervicitis was demonstrated. Hypotheses regarding the latter include nonspecific antiinflammatory effects of metronidazole, its effect on BV flora, and its effect on a specific unrecognized pathogen.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Administration, Oral
  • Administration, Topical
  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Infective Agents / therapeutic use*
  • Doxycycline / administration & dosage
  • Drug Therapy, Combination / therapeutic use*
  • Female
  • Humans
  • Metronidazole / therapeutic use*
  • Ofloxacin / administration & dosage
  • Uterine Cervicitis / drug therapy*
  • Uterine Cervicitis / etiology
  • Vaginosis, Bacterial / complications
  • Vaginosis, Bacterial / drug therapy*

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Metronidazole
  • Ofloxacin
  • Doxycycline