Periodic Presumptive Treatment for Vaginal Infections May Reduce the Incidence of Sexually Transmitted Bacterial Infections

The Journal of Infectious Diseases
Jennifer E BalkusR Scott McClelland

Abstract

Bacterial vaginosis (BV) may increase women's susceptibility to sexually transmitted infections (STIs). In a randomized trial of periodic presumptive treatment (PPT) to reduce vaginal infections, we observed a significant reduction in BV. We further assessed the intervention effect on incident Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium infection. Nonpregnant, human immunodeficiency virus-uninfected women from the United States and Kenya received intravaginal metronidazole (750 mg) plus miconazole (200 mg) or placebo for 5 consecutive nights each month for 12 months. Genital fluid specimens were collected every other month. Poisson regression models were used to assess the intervention effect on STI acquisition. Of 234 women enrolled, 221 had specimens available for analysis. Incidence of any bacterial STI (C. trachomatis, N. gonorrhoeae, or M. genitalium infection) was lower in the intervention arm, compared with the placebo arm (incidence rate ratio [IRR], 0.54; 95% confidence interval [CI], .32-.91). When assessed individually, reductions in STI incidences were similar but not statistically significant (IRRs, 0.50 [95% confidence interval {CI}, .20-1.23] for C. trachomatis infection, 0.56 [95% CI,...Continue Reading

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Citations

May 5, 2017·American Journal of Epidemiology·Erica M LokkenLisa E Manhart
Jul 12, 2017·Obstetrics and Gynecology·Sharon L HillierCarol J Braun
Feb 22, 2018·Sexually Transmitted Diseases·Jennifer E BalkusR Scott McClelland
Nov 15, 2018·Postgraduate Medicine·Suzanne Reiter, Susan Kellogg Spadt
Aug 31, 2019·Journal of the International AIDS Society·Ruth MwatelahSalim S Abdool Karim
Sep 2, 2019·Current Infectious Disease Reports·Jennifer E BalkusR Scott McClelland
Feb 10, 2021·Infection and Immunity·Smritee DabeeHeather B Jaspan
Apr 27, 2021·Frontiers in Cellular and Infection Microbiology·Xiaodi ChenRongguo Li
Feb 13, 2021·The Journal of Infectious Diseases·Susan TuddenhamJeanne M Marrazzo

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