Any two of amsel's criteria may indicate BV. (Ongoing Study).

QUEBEC CITY -- Methods for deeming a patient clinically positive for bacterial vaginosis can be simplified without sacrificing accuracy, Dr. Robert E. Gutman said at the annual meeting of the Infectious Diseases Society for Obstetrics and Gynecology.

Gram staining is the standard for confirming the diagnosis, but it's rarely done outside of research settings. Instead, in everyday practice physicians usually make the diagnosis either very subjectively or by applying one or more of the four criteria, commonly referred to as Amsel's criteria. Under that method, a patient is considered clinically positive for bacterial vaginosis (BV) when she meets at least three of four criteria.

"We believe the current clinical criteria can be simplified, and the presence of two clinical criteria will prove to be of equal sensitivity and specificity" as the current method of requiring the patient to meet three criteria, said Dr. Gutman, chief ob.gyn. resident at Women and Infants Hospital, Providence, R.I.

Our goal is to validate Amsel's criteria to determine whether having three of the four criteria is really necessary to pin down the diagnosis, he said. Dr. Gutman and his associates at the hospital are conducting an ongoing study to do just that.

The four Amsel criteria are:

1. The patient has a thin, homogeneous discharge.

2. Vaginal pH is greater than or equal to 4.5.