{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:59:12Z","timestamp":1792083552391,"version":"4.4.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,4,30]],"date-time":"2020-04-30T00:00:00Z","timestamp":1588204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1 TR000005"],"award-info":[{"award-number":["UL1 TR000005"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although vaginal symptoms are common, diagnosis of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and Trichomonas vaginalis (TV) is not standardized. Diagnostic approaches and appropriateness of treatment were evaluated for women with symptoms of vaginitis who were seeking care at community practice sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Three hundred three symptomatic women, across 8 University of Pittsburgh Medical Center\u2013affiliated clinics, were evaluated per standard office-based practice. Four of 5 vaginal swabs (1 cryopreserved) were collected for a US Food and Drug Administration\u2013authorized nucleic acid amplification test (NAAT) for vaginitis\/vaginosis diagnosis; Nugent scoring (BV); yeast culture (VVC); and a second NAAT (for TV). Two hundred ninety women had evaluable samples. Medical record extraction facilitated verification of treatments prescribed within 7 days of the index visit and return visit frequency within 90 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Women had a mean age of 29.4\u2009\u00b1\u20096.5 years, 90% were not pregnant, 79% were of white race, and 38% reported vaginitis treatment within the past month. Point-of-care tests, including vaginal pH (15%), potassium hydroxide\/whiff (21%), and wet mount microscopy (17%), were rarely performed. Of the 170 women having a laboratory-diagnosed cause of vaginitis, 81 (47%) received 1 or more inappropriate prescriptions. Of the 120 women without BV, TV, or VVC, 41 (34%) were prescribed antibiotics and\/or antifungals. Among women without infectious vaginitis, return visits for vaginitis symptoms were more common among women treated empirically compared to those not receiving treatment (9\/41 vs 5\/79, P = .02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Within a community practice setting, 42% of women having vaginitis symptoms received inappropriate treatment. Women without infections who received empiric treatment were more likely have recurrent visits within 90 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>NCT03151928.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa260","type":"journal-article","created":{"date-parts":[[2020,3,12]],"date-time":"2020-03-12T16:30:49Z","timestamp":1584030649000},"page":"1538-1543","source":"Crossref","is-referenced-by-count":74,"title":["Diagnosis and Treatment of Vaginal Discharge Syndromes in Community Practice Settings"],"prefix":"10.1093","volume":"72","author":[{"given":"Sharon L","family":"Hillier","sequence":"first","affiliation":[{"name":"Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA"},{"name":"University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Austin","sequence":"additional","affiliation":[{"name":"Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Macio","sequence":"additional","affiliation":[{"name":"Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie A","family":"Meyn","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Badway","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Beigi","sequence":"additional","affiliation":[{"name":"Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA"},{"name":"University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,4,30]]},"reference":[{"key":"2021050500481444700_CIT0001","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1097\/OLQ.0b013e318074e565","article-title":"The prevalence of bacterial vaginosis in the United States, 2001\u20132004; associations with symptoms, sexual behaviors, and reproductive health","volume":"34","author":"Koumans","year":"2007","journal-title":"Sex Transm Dis"},{"key":"2021050500481444700_CIT0002","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1086\/522532","article-title":"The prevalence of Trichomonas vaginalis infection among reproductive-age women in the United States, 2001\u20132004","volume":"45","author":"Sutton","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2021050500481444700_CIT0003","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1086\/657320","article-title":"Bacterial vaginosis assessed by Gram stain and diminished colonization resistance to incident gonococcal, chlamydial, and trichomonal genital infection","volume":"202","author":"Brotman","year":"2010","journal-title":"J Infect Dis"},{"key":"2021050500481444700_CIT0004","doi-asserted-by":"crossref","first-page":"e1001251","DOI":"10.1371\/journal.pmed.1001251","article-title":"Bacterial vaginosis associated with increased risk of female-to-male HIV-1 transmission: a prospective cohort analysis among African couples","volume":"9","author":"Cohen","year":"2012","journal-title":"PLoS Med"},{"key":"2021050500481444700_CIT0005","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1515\/JPM.2009.026","article-title":"Preterm labor and bacterial vaginosis-associated bacteria among urban women","volume":"37","author":"Nelson","year":"2009","journal-title":"J Perinat Med"},{"key":"2021050500481444700_CIT0006","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1086\/511278","article-title":"Infection with Trichomonas vaginalis increases the risk of HIV-1 acquisition","volume":"195","author":"McClelland","year":"2007","journal-title":"J Infect Dis"},{"key":"2021050500481444700_CIT0007","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1097\/00007435-199707000-00008","article-title":"Trichomonas vaginalis associated with low birth weight and preterm delivery. 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