{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T23:11:36Z","timestamp":1793747496608,"version":"4.6.1"},"reference-count":146,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:p>\n                    Bacterial vaginosis (BV) is a common cause of vaginitis worldwide and is associated with serious reproductive health outcomes, including increased risk of preterm birth, sexually transmitted infections, and pelvic inflammatory disease. The current and only FDA-approved treatment regimens for BV are antibiotics, such as metronidazole and clindamycin. Antibiotics provide a short-term cure for bacterial vaginosis; however, fail to provide a consistent long-term cure for many women. Fifty to eighty percent of women experience a BV recurrence within a year of completing antibiotic treatment. This may be because after antibiotic treatment, beneficial strains of\n                    <jats:italic>Lactobacillus<\/jats:italic>\n                    , such as\n                    <jats:italic>L. crispatus,<\/jats:italic>\n                    do not recolonize the vagina. In the absence of an effective long-term cure, patients, providers, and researchers are exploring different approaches to treatment and prevention, resulting in a rapid evolution of perspectives on BV pathogenesis and approaches to management. Current areas of investigation for BV management include probiotics, vaginal microbiome transplantation, pH modulation, and biofilm disruption. Behavioral modifications that may help include smoking cessation, condom use and hormonal contraception. Additional strategies considered by many people include dietary modification, non-medical vaginally applied products, choice of lubricant, and treatments from medical practices outside of allopathic medicine. This review aims to provide a comprehensive and up to date outline of the landscape of ongoing and potential treatment and prevention strategies for BV.\n                  <\/jats:p>","DOI":"10.3389\/frph.2023.1100029","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T01:11:00Z","timestamp":1685495460000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":120,"title":["Bacterial vaginosis: a review of approaches to treatment and prevention"],"prefix":"10.3389","volume":"5","author":[{"given":"Carmen","family":"Abbe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline M.","family":"Mitchell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1111\/1471-0528.14209","article-title":"Bacterial vaginosis: a critical analysis of current knowledge","volume":"124","author":"Nasioudis","year":"2017","journal-title":"BJOG"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0080074","article-title":"Vaginal pH and microbicidal lactic acid when lactobacilli dominate the microbiota","volume":"8","author":"O\u2019Hanlon","year":"2013","journal-title":"PLoS One"},{"key":"B3","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1007\/s00203-014-1003-1","article-title":"Bacteriocin production and gene sequencing analysis from vaginal Lactobacillus strains","volume":"196","author":"Stoyancheva","year":"2014","journal-title":"Arch Microbiol"},{"key":"B4","author":"Colonna","year":""},{"key":"B5","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1097\/AOG.0000000000002090","article-title":"Clinical validation of a test for the diagnosis of vaginitis","volume":"130","author":"Gaydos","year":"2017","journal-title":"Obstet Gynecol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1128\/jcm.29.2.297-301.1991","article-title":"Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation","volume":"29","author":"Nugent","year":"1991","journal-title":"J Clin Microbiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1097\/OLQ.0b013e318074e565","article-title":"The prevalence of bacterial vaginosis in the United States, 2001\u22122004; associations with symptoms, sexual behaviors, and reproductive health","volume":"34","author":"Koumans","year":"2007","journal-title":"Sex Transm Dis"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/4919404","article-title":"Prevalence of bacterial vaginosis and associated risk factors among women complaining of genital tract infection","volume":"2017","author":"Bitew","year":"2017","journal-title":"Int J Microbiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1478","DOI":"10.1086\/503780","article-title":"High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence","volume":"193","author":"Bradshaw","year":"2006","journal-title":"J Infect Dis"},{"key":"B10","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.ejogrb.2019.12.035","article-title":"Bacterial vaginosis\u2014a brief synopsis of the literature","volume":"245","author":"Coudray","year":"2020","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.1089\/jwh.2018.7383","article-title":"Characterization and treatment of recurrent bacterial vaginosis","volume":"28","author":"Faught","year":"2019","journal-title":"J Womens Health (Larchmt)"},{"key":"B12","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1136\/bmj.308.6924.295","article-title":"Abnormal bacterial colonisation of the genital tract and subsequent preterm delivery and late miscarriage","volume":"308","author":"Hay","year":"1994","journal-title":"Br Med J"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1056\/NEJM199512283332604","article-title":"Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. 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