The effects of intravaginal clindamycin and metronidazole therapy on vaginal lactobacilli in patients with bacterial vaginosis.
OBJECTIVE
The purpose of this study was to determine the effects of 3 intravaginal antibacterial treatments on vaginal lactobacilli in patients with bacterial vaginosis (BV).


METHODS
Retrospective analyses were performed on Lactobacillus scores from 3 similar studies evaluating 2 2% clindamycin vaginal creams and 0.75% metronidazole gel at baseline and at 21 to 30 days in 408 patients with BV. Scores were compared using a 1-way global F test and McNemar's test.


RESULTS
All groups had similar mean Lactobacillus scores at baseline (P = 0.37) and at 21 to 30 days (P = .71). The 3 groups were also comparable at both visits with respect to the distributions of scores within each group. In all groups, there was significant improvement in the percentages of patients with no lactobacilli present at 21 to 30 days compared with baseline (P < .0001 for all comparisons).


CONCLUSIONS
Clindamycin and metronidazole promoted similar levels of restoration of vaginal lactobacilli at 21 to 30 days.
Nyirjesy
Paul
P
Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA 19102, USA. pnyirjes@drexelmed.edu
McIntosh
Matthew J
MJ
Gattermeir
David J
DJ
Schumacher
Robert J
RJ
Steinmetz
Jana I
JI
Joffrion
James L
JL
D000282:Administration, Intravaginal; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002981:Clindamycin / Q000008:administration & dosage* / Q000627:therapeutic use; D015169:Colony Count, Microbial; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007778:Lactobacillus / Q000187:drug effects*; D008795:Metronidazole / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014621:Vagina / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D002981:Clindamycin