Update zur bakteriellen Vaginose

Bacterial vaginosis (BV) is a multifactorial syndrome that is characterized by a greatly increased number of bacteria, in particular of Gardnerella spp. The BV can be a dysbiotic state, a sexually transmitted infectious disease, a biofilm-related condition or even a subjectively asymptomatic normal condition with increased gynecological and obstetric morbidity. Due to the high rate of treatment failures, BV frequently represents an enormous challenge in the clinical routine. In addition to phase-contrast microscopy as a first-line diagnostic tool in gynecological practices, molecular genetic examinations, such as fluorescence in situ hybridization (FISH), polymerase chain reaction (PCR) or next generation sequencing (NGS) are also available. Certain risk factors for BV exist as well as predisposing host factors, where particular attention is needed, especially in the clarification and prevention of BV recurrence. Women with vulvovaginal complaints should always be examined for BV and treatment should only be initiated following correctly carried out and medically confirmed diagnostics. Treatment strategies include antibiotic treatment with oral or topical clindamycin or metronidazole, with local antiseptics as an alternative treatment. There are indications that lactic acid and probiotics have a positive effect as a complementary treatment and to avoid BV recurrence. Future research in the field of BV should focus on the avoidance of high recurrence rates and chronically recurring courses. This review article provides a summary of current strategies in the classification and treatment of women with BV; it does not replace the discussion on current guidelines and valid recommendations.