Combined oral contraceptive pill-exposure alone does not reduce the risk of bacterial vaginosis recurrence in a pilot randomised controlled trial

Vodstrcil, L, Plummer, E, Fairley, C and Tachedjian, G., et al, 2019, 'Combined oral contraceptive pill-exposure alone does not reduce the risk of bacterial vaginosis recurrence in a pilot randomised controlled trial', Scientific Reports, vol. 9, no. 1, pp. 1-18.


Document type: Journal Article
Collection: Journal Articles

Title Combined oral contraceptive pill-exposure alone does not reduce the risk of bacterial vaginosis recurrence in a pilot randomised controlled trial
Author(s) Vodstrcil, L
Plummer, E
Fairley, C
Tachedjian, G., et al,
Year 2019
Journal name Scientific Reports
Volume number 9
Issue number 1
Start page 1
End page 18
Total pages 18
Publisher Nature
Abstract We conducted a pilot open-label randomised controlled trial of combined (oestrogen-progesterone) oral contraceptive pill (COCP)-exposure aimed to examine its effect on BV-recurrence following first-line antibiotics compared to antibiotics alone. Ninety-five women with symptomatic BV were prescribed antibiotic therapy, randomised to COCP-exposure (intervention) or current non-hormonal contraceptive practices (control) and followed monthly for six-months or until BV-recurrence. Modified intention-to-treat methods requiring either >= 1 clinical (primary/Amsel-outcome) or >= 1 microbiological (secondary/Nugent-outcome) BV-recurrence assessment were applied to determine cumulative recurrence rates. Secondary Cox regression analyses assessed factors associated with recurrence in all women. 92/95 women randomised provided baseline requirements. BV-recurrence rates were similar in women randomised to the COCP (primary/Amsel-outcome: 10/100PY, 95%CI: 6,19/100PY) compared to controls (14/100PY, 95%CI: 9, 21/100PY, p = 0.471). In secondary analyses sex with the same pre-treatment regular sexual partner (RSP; Amsel: Adjusted Hazard Ratio [AHR] = 3.13, 95%CI: 1.41, 6.94, p = 0.005; Nugent: AHR = 2.97, 95%CI: 1.49, 5.83, p =0.002) and BV-history (Amsel: AHR= 3.03, 95%CI: 1.14, 6.28; Nugent: AHR = 2.78, 95%CI: 1.22, 6.33) were associated with increased BV-recurrence. This pilot RCT of COCP-exposure did not improve BV cure but found sex with an RSP and By-history were associated with recurrence, although impacted by sample size and attrition. These data indicate reinfection from an untreated RSP and persistence of BV-associated bacteria are integral to the pathogenesis of recurrence and may overwhelm potential beneficial effects of hormonal contraception on the vaginal microbiota.
Subject Microbiology not elsewhere classified
Keyword(s) Lactic-Acid
Treatment Failure
Epithelial-Cells
Sexual Partners
Metronidazole
Biofilms
Immunity
Women
DOI - identifier 10.1038/s41598-019-39879-8
Copyright notice © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License
ISSN 2045-2322
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 0 times in Thomson Reuters Web of Science Article
Scopus Citation Count Cited 0 times in Scopus Article
Altmetric details:
Access Statistics: 0 Abstract Views  -  Detailed Statistics
Created: Fri, 05 Jul 2019, 12:33:00 EST by Catalyst Administrator
© 2014 RMIT Research Repository • Powered by Fez SoftwareContact us