Bacterial Vaginosis Recurrence Drops with Partner Treatment: Daily Dose

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On March 28, 2025, we reported on a study published in the New England Journal of Medicine that aimed to determine whether treating male partners with antimicrobial therapy would decrease the recurrence of bacterial vaginosis (BV) in women.

The study

Researchers conducted the open-label trial from April 2019 through November 2023 involving couples in which the woman had BV and was in a monogamous relationship with a male partner.

Participants were divided into 2 groups: one in which only the woman received standard first-line BV treatment, and another in which both the woman and her male partner received treatment. The male partners in the treatment group were prescribed oral metronidazole (400 mg) and topical clindamycin cream (2%) applied to the penile skin, both administered twice daily for 7 days. The primary endpoint was BV recurrence within 12 weeks. Of the 357 couples assessed for eligibility, 164 underwent randomization, with 81 assigned to the partner-treatment group and 83 to the control group.

The study was halted early by the data and safety monitoring board after 150 couples completed the 12-week follow-up, as results demonstrated a clear benefit of treating male partners.

The findings

Recurrence of BV occurred in 24 of 69 women (35%) in the partner-treatment group (recurrence rate, 1.6 per person-year; 95% CI, 1.1 to 2.4) compared with 43 of 68 women (63%) in the control group (recurrence rate, 4.2 per person-year; 95% CI, 3.2 to 5.7). This corresponded to an absolute risk difference of –2.6 recurrences per person-year (95% CI, –4.0 to –1.2) and a 63% lower risk of recurrence (HR, 0.37; 95% CI, 0.22-0.61) among women in the partner-treatment group.

Authors' comments

"The addition of combined oral and topical antimicrobial therapy for male partners to treatment of women for bacterial vaginosis resulted in a lower rate of recurrence of bacterial vaginosis within 12 weeks than standard care."

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