Effectiveness and safety of metronidazole plus probiotics versus metronidazole alone in the treatment of bacterial vaginosis: randomized controlled trial
Abstract
Background. Ingestion of probiotics can potentially restore the normal flora of the vagina and help in the treatment of bacterial vaginosis (BV).
Objective. To compare the effectiveness and safety of metronidazole plus probiotics versus metronidazole alone in treating women with BV.
Design. Open-label randomized controlled trial.
Setting. Outpatient Gynecology Clinic at Southern Philippines Medical Center in Davao City, Philippines.
Participants. 60 women 18-49 years old diagnosed to have BV by Nugent's criteria.
Intervention. Participants were randomized to receive either oral metronidazole 500 mg twice daily for 7 days, followed by oral probiotics one capsule once daily for 7 days, or oral metronidazole 500 mg twice daily for 7 days alone.
Main outcome measures. Cure rates two weeks after start of treatment; and recurrence rates within the succeeding 10 weeks after being cured from initial treatment.
Main results. The metronidazole alone (MA) group and metronidazole plus probiotics (MP) group were comparable in terms of demographic and clinical characteristics at baseline. After two weeks of treatment, cure rates were 22/30 (73.33%) in the MA group and 20/30 (66.67%) in the MP group (p=0.8071). Recurrence rate within three months was 5/22 (22.73%) in the MA group and 4/20 (20%) in the MP group (p=0.8297).
Conclusion. A metronidazole regimen with an added course of probiotics did not significantly differ from metronidazole alone in terms of BV cure rates two weeks after start of treatment and recurrence rates within 10 weeks after being cured.
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