New concepts in bacterial vaginosis.

Bacterial vaginosis is a polymicrobial, superficial infection caused by an increase in anaerobic bacteria and a concomitant decrease in lactobacilli. Diagnosis is based on the presence of three of the following findings: a homogeneous vaginal discharge; an amine odor released by the addition of 10 percent potassium hydroxide; the presence of clue cells on wet mount; the absence of lactobacilli on wet mount, and an increase in the pH of vaginal secretions to more than 4.7. Oral metronidazole is the drug of choice for the treatment of bacterial vaginosis, but clindamycin is an effective alternative.