title: [Treatment of bacterial vaginosis with high dosage metronidazole and lactic acid].
abstract: BACKGROUND
  Bacterial vaginosis (BV) is one of the most frequent vaginal infections in women of reproductive age. This condition is a disbalance of vaginal flora that is expressed in a considerable displacement of normal lactobacilli flora by opportunistic and facultative microorganisms. Despite the moderate or missing clinical manifestation this dysbacteriosis is linked with many complications in obstetrics and gynecology.
  
  
  OBJECTIVE
  To evaluate the effect of treatment of bacterial vaginosis with the product Arilin rapid containing vaginal Metronidazole in high doses and a following vaginal application of lactic acid in a part of the patients.
  
  
  METHODS
  For the period May 2001-August 2001, bacterial vaginosis was established in 45 patients of the Specialized hospital for active treatment in obstetrics and gynecology "Maichin Dom", Sofia and the Military medical academy-Sofia, gynecology ward. The diagnosis of bacterial vaginosis was established in accordance to Amsel's criteria and the results that were obtained from samples colored by Gram. For the treatment of BV were used local Metronidazole (Arilin rapid) and vaginal tablets containing lactic acid. The patients were divided into 3 groups. In the first group (18 women) vaginal suppositoria of 100 mg Metronidazole (Arilin rapid) were used for 2 days, in the second (20 women)--Arilin rapid x 1 glob./2 days and a following therapy with vaginal tablets containing lactic acid x 1 glob. for 7 days. The third group (7 women) was the control receiving placebo therapy--shampoo Dercome Femme containing lactic acid for external application.
  
  
  RESULTS
  In the group receiving Arilin rapid we observed a normalization of vaginal flora in 71.43% (5/7), intermediate vaginal flora in 14.3% (1/7) and no change caused by therapy in 14.3% (1/7). In the second group, where lactic acid was included, cure was established in 94.1% (16/17) and in only one (5.9%) case was established intermediate vaginal flora. In the control group in 85.7% (6/7) of the cases was registered a lack of effect.
  
  
  CONCLUSIONS
  Treatment with Arilin rapid showed good results in 71% of cases. Adding lactate to therapy improved the therapeutic effect and achieved cure in over 94%. The following application of vaginal lactate is an additional step helping the recolonisation of the vagina with lactobacilli and is a contribution to the struggle with recurrent forms.
authors.affiliation: Specialized Hospital for Active Treatment in Obstetrics and Gynecology Maichin Dom, Sofia.
authors.forename: P
authors.initials: P
authors.lastname: Andreeva
authors.forename: B
authors.initials: B
authors.lastname: Slavchev
authors.forename: S
authors.initials: S
authors.lastname: Kovachev
authors.forename: A
authors.initials: A
authors.lastname: Nacheva
authors.forename: R
authors.initials: R
authors.lastname: Vacheva
mesh_terms: D000282:Administration, Intravaginal; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D016585:Vaginosis, Bacterial / Q000188:drug therapy*
chemical_list: D000890:Anti-Infective Agents; D008795:Metronidazole; D019344:Lactic Acid