OxyFile #254

Recurrent bacterial vaginosis--an old approach to a new 

Author:  Winceslaus SJ; Calver G

Source:   Int J STD AIDS 1996 Jul; 7(4):284-7


Bacterial vaginosis (BV) is a common cause of abnormal 
malodorous vaginal discharge and can be frustrating to 
manage in its recurrent form. Metronidazole is the standard 
treatment, but is unacceptable to many women when given 
repeatedly. Results of treating recurrent BV using a single 
vaginal washout with 3% hydrogen peroxide are analysed. 
A total of 30 symptomatic women with clinically confirmed 
recurrent BV in the absence of other genital infections 
were recruited after informed consent. Hydrogen peroxide 
(3%) was instilled into the vagina, left for 3 minutes 
and drained. Reassessment was at 3 weeks after treatment. 
A total of 23 women completed the study. Symptoms cleared 
completely in 78% (18/23), improved in 13% (3/23) and remained 
unchanged in 9% (2/23). All the 3 women with improved symptoms 
had a mild vaginal discharge, but only one of them was 
still able to perceive the malodour. The amine test was 
negative in all 23 women including the 2 (9%) who felt 
no change in their symptoms following treatment. Mixed 
anaerobes isolated in all women before treatment were not 
re-isolated, and microscopy did not show 'clue cells' in 
the vaginal discharge following treatment. Vaginal acidity 
was restored to normal in all but one (96%). No side-effects 
were observed in the treated women. Hydrogen peroxide (3%) 
used as a single vaginal wash was as effective as any other 
agent in current use in clearing the vaginal malodour of 
bacterial vaginosis at 3 weeks after treatment.