High antibiotics prescription and frequent STIs tied to High risk of Bacterial Vaginosis

Netherlands: A new study found that recurrence of bacterial vaginosis was mostly seen in patients who were frequently prescribed antibiotics and who were suffering from a family history of sexually transmitted diseases. They also suggested that there should be more in-person consultations and general practitioners should use standardized diagnostic criteria and microbiological testing in recurrence cases. The study results were published in the journal Family Practice. 

The most commonly encountered problem in primary care is Bacterial vaginosis (BV). The symptoms of BV often hurt the patients' quality of life and may predispose them to gynecological problems. Recurrent episodes are experienced by some patients of BV. Hence researchers from the Netherlands conducted a study to identify possible factors that may be associated with BV recurrence and describe the characteristics of these patients and interventions performed by general practitioners. 

A retrospective cohort study was conducted by using data from a primary care registration network in the Netherlands in the period 2015-2020. The differences between patients with recurrent BV and patients with a single episode of BV were analyzed in terms of characteristics and interventions performed by general practitioners.

Key findings:

• A significantly increased recurrence of BV was seen in patients with recently prescribed antibiotics, and a medical history of sexually transmitted infections and/or Candidiasis.
• There were more remote consultations and fewer in-person consultations in patients with recurrent BV than in single-episode patients.
• The common reason for encounter was more often a medication request. 
• GPs used microbiological tests as the most frequent diagnostic and therapeutic interventions, in recurrent BV patients.
• Oral Metronidazole was the most frequently prescribed antibiotic in both groups. 

Thus, the study showed certain insights to the GPs on evaluating their approach to the diagnosis and treatment of recurrent BV. 

Further reading: Delfstra NS, Uijen AA, Vos MC, Akkermans R, Lagro-Janssen AL, Teunissen DAM. Patient characteristics and factors contributing to recurrence of bacterial vaginosis presented in primary care [published online ahead of print, 2023 Jan 27]. Fam Pract. 2023;cmad005. doi: 10.1093/fampra/cmad005