{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:02:20Z","timestamp":1789542140459,"version":"build-2803163510"},"reference-count":36,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AI061628"],"award-info":[{"award-number":["R01 AI061628"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bacterial vaginosis (BV) is the most common cause of vaginal discharge syndrome and is usually treated with metronidazole. BV frequently recurs. Published studies have not linked measured vaginal antibiotic activity (VAA) or antibiotic concentrations to clinical or microbiological BV outcomes. The objective was to determine if VAA in vaginal fluid after diagnosis of BV is associated with persistent\/recurrent BV or changes in concentrations of vaginal BV-associated bacteria (BVAB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>VAA was assessed using a bioassay to measure inhibition of growth of BVAB in culture. Persistent\/recurrent BV was measured by Amsel clinical criteria at days 6\u201335 (early) and 36\u2013100 (late), concentrations of indicator BVAB in the vagina by quantitative polymerase chain reaction (PCR), and condom use by questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighty-seven participants who experienced 130 episodes of BV were prescribed metronidazole. No VAA was detected in 40 of 130 (31%) episodes of BV in the 10 days postdiagnosis. VAA was linked to significantly greater declines in vaginal concentrations of indicator BVAB (P &amp;lt; .001). Persistent\/recurrent BV was present in 38 of 129 (29%) episodes at days 6\u201335, and 45 of 63 (71%) episodes at days 36\u2013100. In a multivariable model, VAA on the majority of prescribed days was associated with a reduced risk for recurrent BV at days 6\u201335 in the absence of condomless sex (relative risk, 0.31; 95% CI, .11\u2013.89; P = .03), but not when condomless sex was reported (P = .49). No associations between VAA and BV recurrence at days 36\u2013100 were found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The combination of metronidazole detection on the majority of prescribed days and condom use is associated with reduced risk of BV recurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiag412","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T11:52:06Z","timestamp":1786189926000},"source":"Crossref","is-referenced-by-count":0,"title":["An Observational Study of Vaginal Antibacterial Activity and Outcomes After Antibiotic Prescription for Bacterial Vaginosis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2735-6800","authenticated-orcid":false,"given":"David N","family":"Fredricks","sequence":"first","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]},{"name":"Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0029-8511","authenticated-orcid":false,"given":"Elizabeth M","family":"Krantz","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0671-9880","authenticated-orcid":false,"given":"Sean","family":"Proll","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9714-9758","authenticated-orcid":false,"given":"Congzhou","family":"Liu","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina L","family":"Fiedler","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7845-2013","authenticated-orcid":false,"given":"Susan M","family":"Strenk","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5954-8810","authenticated-orcid":false,"given":"Danijel","family":"Djukovic","sequence":"additional","affiliation":[{"name":"Northwest Metabolomics Research Center, Department of Anesthesiology and Pain Medicine, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Mitochondria and Metabolism Center, Department of Anesthesiology and Pain Medicine, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Public Health Sciences Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2467-8118","authenticated-orcid":false,"given":"Daniel","family":"Raftery","sequence":"additional","affiliation":[{"name":"Northwest Metabolomics Research Center, Department of Anesthesiology and Pain Medicine, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Mitochondria and Metabolism Center, Department of Anesthesiology and Pain Medicine, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Public Health Sciences Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujatha","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"2026091602062868900_jiag412-B1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1038\/s41572-025-00626-1","article-title":"Bacterial vaginosis","volume":"11","author":"Bradshaw","year":"2025","journal-title":"Nat Rev Dis 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