Empiric treatment of minimally abnormal papanicolaou smears with 0.75% metronidazole vaginal gel.
BACKGROUND
The purpose of this study was to compare the efficacy of 0.75% metronidazole vaginal gel with no treatment in patients who have had a minimally abnormal Papanicolaou smear.


METHODS
One hundred forty-five patients whose initial Papanicolaou smears were limited by inflammation or benign cellular changes, reactive cellular changes, or atypical squamous cells of undetermined significance that did not favor a neoplastic process were randomized to 5 days of treatment with 0.75% metronidazole vaginal gel or to a control group receiving no treatment. Papanicolaou smears were repeated after 3 to 4 months.


RESULTS
Cytologic findings of the follow-up Papanicolaou smears were normal in 61 of 114 (54%) of patients. Sixty-two percent (n = 37) of the Papanicolaou smears in the control group converted to normal on follow-up, whereas 44% (n = 24) of the Papanicolaou smears in the treatment group converted to normal (P = .07). Only one follow-up Papanicolaou smear worsened to low-grade squamous intraepithelial lesion. In no subgroup was treatment effective.


CONCLUSIONS
Empiric treatment for an asymptomatic, minimally abnormal Papanicolaou smear with 0.75% metronidazole vaginal gel before a repeated cytologic examination did not improve the rate of reversion to normal cytologic findings.
D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000517:prevention & control*; D002584:Cervix Uteri / Q000166:cytology / Q000473:pathology*; D036262:Empirical Research; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use*; D065006:Papanicolaou Test; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears / Q000145:classification
D000890:Anti-Infective Agents; D008795:Metronidazole