Counsel about douching: bacterial vaginosis a risk for teens at STD clinics.(Gynecology)

PLAYA HERRADURA, COSTA RICA -- Almost 25% of adolescent girls studied at two STD clinics had at least one episode of bacterial vaginosis, Rebecca Brotman said at a conference on vaginitis sponsored by Imedex.

Although sexually active adolescents are at high risk for acquisition of sexually transmitted infection, few researchers have specifically looked at bacterial vaginosis (BV) in this population.

"We were interested in studying BV characteristics in high-risk adolescent girls in order to determine whether age-specific interventions are warranted to try and decrease the costly sequelae of this infection," explained Ms. Brotman, a doctoral student in infectious disease epidemiology at the Johns Hopkins Bloomberg School of Public Health, Baltimore.

Ms. Brotman and her colleagues compared 75 girls with recurrent BV (at least three episodes) with 300 controls. The adolescents were 11-18 years old and were selected from a database of all clinical visits to two public STD clinics in Baltimore between 1990 and 2001. Control adolescents had no BV at any clinic visit. HIV-positive patients were excluded. Diagnosis of BV was based on the presence of three out of four Amsel criteria. Participants with BV were treated with oral metronidazole, Ms. Brotman said.

Counseling and treatment of adolescents with BV may be different from that for adults because of biological and behavioral differences. For example, adolescents may be more reluctant to admit use of alcohol because they are under the legal drinking age. But alcohol can interact with metronidazole treatment, so clinicians should pay particular attention to counseling patients suspected of concomitant alcohol use--or alternative treatments should be considered.

The database, compiled over an 11-year period, included 4,687 adolescents and 10,067 visits. A total of 1,103 patients had 1,443 episodes of BV. The 75 cases in the study represent 6.8% of all individuals with BV identified during a clinic visit. The mean number of visits to a clinic was five. The patient population was 97% African American. "Obviously, caution is ...