An Australian randomized controlled trial published in the New England Journal of Medicine found that treating the male sexual partners of women with bacterial vaginosis (BV) significantly lowered the recurrence rate of the infection. The study showed that only 35% of women experienced a recurrence when both they and their male partners received treatment, compared to 63% of women who were treated alone without partner treatment. Recurrence rates were 1.6 per person-year in the partner-treatment group compared to 4.2 per person-year in the control (hazard ratio [HR] 0.37, 95% confidence interval [CI] 0.22-0.61) within 12 weeks of treatment. While all female participants stuck with their prescribed regimen (taking at least 70% of the medication), only 86% of male partners reached that adherence level. Further analysis indicated that women whose partners fully complied with treatment had the lowest recurrence rate (1.3 per person-year, 95% CI 0.7-2.6). The trial included women with BV who were in monogamous heterosexual relationships with all participants receiving standard first-line antimicrobial therapy. Male partners in the intervention group of 81 couples were treated with 400 mg of metronidazole and 2% clindamycin cream, applied twice daily for 7 days, while men in the control group of 83 couples received no treatment.
One-two punch: The researchers emphasized that their dual-therapy approach—combining topical and oral antibiotics to target bacteria on the penile skin and within the urethra—was likely key to the trial’s success. They also highlighted the importance of viewing BV treatment as a shared responsibility between male and female partners.