Metronidazole for bacterial vaginosis. A comparison of vaginal gel vs. oral therapy.
OBJECTIVE
To compare the efficacy and safety of 0.75% metronidazole vaginal gel with oral metronidazole for the treatment of bacterial vaginosis (BV).


METHODS
Nonpregnant women with BV were enrolled in a multicenter, randomized, investigator-blind treatment trial. Patients were randomly assigned to either 0.75% metronidazole vaginal gel (5 g twice daily for five days) or oral metronidazole (500 mg twice daily for seven days). Follow-up visits occurred approximately two and five weeks after initiation of therapy.


RESULTS
BV was clinically eliminated at the first follow-up visit in 83.7% (36/43, 95% CI 72.3-95.1%) of the intravaginal group and 85.1% (40/47, 95% CI 74.6-95.6%) of the oral group. At the final visit, BV was eliminated in 70.7% (29/41, 95% CI 56.3-85.1%) of the intravaginal group and 71.1% (32/45, 95% CI 57.4-84.8%) of the oral group. Significantly more patients in the oral treatment group (51.8%) reported gastrointestinal complaints as compared to the intravaginal treatment group (32.7%, P = .04).


CONCLUSIONS
The efficacy of 0.75% metronidazole vaginal gel twice daily for five days in treating BV was similar to that of standard oral metronidazole treatment and was associated with fewer gastrointestinal complaints.
Hanson
J M
JM
Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Denver, USA.
McGregor
J A
JA
Hillier
S L
SL
Eschenbach
D A
DA
Kreutner
A K
AK
Galask
R P
RP
Martens
M
M
D000282:Administration, Intravaginal; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000145:classification / Q000453:epidemiology; D005782:Gels; D006801:Humans; D015994:Incidence; D008795:Metronidazole / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D016585:Vaginosis, Bacterial / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology
D000890:Anti-Infective Agents; D005782:Gels; D008795:Metronidazole