Treatment with metronidazole did not reduce post-abortion complications in women with suspected bacterial vaginosis

In summary, treatment with metronidazole of women who screen positive with a self-diagnosis test card for the presence of bacterial vaginosis prior to surgical abortion did not reduce the risk of post-abortal infectious complications in a population of women undergoing surgical abortion and receiving doxycycline therapy. However, the limitations of the study - poor specificity of the screening test, treatment of asymptomatic infection, and limited follow-up - resulted in insufficient power (30%) to detect a clinical effect of a 10% difference in the PACS. Whether women with symptomatic BV infections would benefit from therapy with metronidazole in addition to typical surgical prophylaxis remains to be determined. Clinicians providing abortion care should continue to use their clinical judgment to assess the appropriateness of anaerobic therapy.