title: [Efficacy of combined 5-nitroimidazole and probiotic therapy of bacterial vaginosis: randomized open trial].
abstract: The aim of the current research is to identify the clinical and microbiological effect of 5-nitroimidazol therapy for the treatment of bacterial vaginosis and in combination with probiotics and the influence of such therapy upon vaginal flora.
  
  
  METHODS
  Women (n = 539) with bacterial vaginosis who meet the criteria were included in the study. They were randomized into two groups with the following therapeutic regimes: in the first group (n = 242 women) the treatment included applications of 2g BID tinidazole for two days and vaginal suppositories of 1000 mg metronidazol at day 1 and 3 (T+M). In the second group (n = 297) the women were cured with the same treatment as those in the first group. In addition to it from the fifth day of the treatment was added a topical administration of vaginal probiotic which contains species of alive lactobacilli: Lactobacillus acidophilus, Lactobacillus rhamnosus (T+M+P). The efficacy from the therapy was evaluated using the clinical compliances of the women, the data from the clinical examination and the microbiological tests results.
  
  
  RESULTS
  The results showed expected increase of clinical therapy efficacy (Amsel - criteria) from 42.8% (T+M; n = 211/242) to 84.06% (T+M+P; n = 274/297) in groups and of microbiological efficacy (Nugent) from 44.7% (T+M; n = 211/242) to 83.3% (T+M+P; n = 274/297), in follow up 35-40 days from the beginning of treatment. The percentage of women with normal vaginal flora on 35-40 day after the therapy increase with 57% in the (T+M) first group while in the second group (T+M+P) with 94%.
  
  
  CONCLUSIONS
  Combining the therapies of 5-nitroimidazoles and vaginal probiotic reduce bacterial vaginosis recurrence and restores permanently normal vaginal flora.
authors.forename: S
authors.initials: S
authors.lastname: Kovachev
authors.forename: R
authors.initials: R
authors.lastname: Vatcheva-Dobrevski
mesh_terms: D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007779:Lactobacillus acidophilus / Q000502:physiology; D052201:Lacticaseibacillus rhamnosus / Q000502:physiology; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D009593:Nitroimidazoles / Q000627:therapeutic use*; D019936:Probiotics / Q000627:therapeutic use*; D014011:Tinidazole / Q000627:therapeutic use*; D014621:Vagina / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D009593:Nitroimidazoles; D014011:Tinidazole; D008795:Metronidazole; C052587:4-nitroimidazole