What prophylactic treatments are effective for patients with recurrent bacterial vaginosis?

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Evidence-Based AnswerIn patients with recurrent bacterial vaginosis (BV) who have just completed therapy for active disease, intravaginal probiotics for 14 additional days or intravaginal metronidazole gel 0.75% twice a week for 16 weeks decreases the recurrence rate (SOR: B, small RCTs). A 5-day course of intravaginal probiotic followed by a 5-day course of intravaginal metronidazole gel 0.75% after each menses may also lower the recurrence rate (SOR: C, low-quality cohort study).

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