Interrelationships of bacterial vaginosis and cervical inflammation.
BACKGROUND
Women with cervicitis frequently have bacterial vaginosis (BV). Prior studies have suggested that BV is involved in the pathogenesis of cervicitis.


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


METHODS
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.


CONCLUSIONS
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.
Schwebke
Jane R
JR
Department of Medicine and Biostatistics Center, University of Alabama at Birmingham, USA. schwebke@uab.edu
Weiss
Heidi L
HL
D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D004318:Doxycycline / Q000008:administration & dosage; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use*; D015242:Ofloxacin / Q000008:administration & dosage; D002575:Uterine Cervicitis / Q000188:drug therapy* / Q000209:etiology; D016585:Vaginosis, Bacterial / Q000150:complications / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D015242:Ofloxacin; D004318:Doxycycline