title: Effects of metronidazole combined probiotics over metronidazole alone for the treatment of bacterial vaginosis: a meta-analysis of randomized clinical trials.
abstract: OBJECTIVE
  To evaluate the curative effect of metronidazole combined probiotics over metronidazole alone in the treatment of BV.
  
  
  METHODS
  We are searching randomized controlled trials on major online databases including PubMed, Science Direct, and Cochrane Database between 1990 and 2015. The primary outcome measure was the cure rate of BV. Cochran's Chi-square test (Q test) was used to test for heterogeneity among trials, and the I2index. We used mixed-effects modeling for parameters of the summary hazard ratios (HRs), odds ratios (ORs), and their 95% confidence intervals (CIs).
  
  
  RESULTS
  Analysis suggests the cure rate of BV [RR = 1.12, 95% CI (0.94-1.32), p = 0.20], and the I2index was 83%. The value of I2index decreased to 16% after removing the study of Anukam et al., and Amsel 1.04 (95% CI 0.96-1.13) (p = 0.35), Nugent 1.02 (95% CI 0.94-1.11), short-term 1.01 (95% CI 0.93-1.10) (p = 0.79), long-term 1.06 (95% CI 0.98-1.14) (p = 0.13), Europe 1.06 (95% CI 0.95-1.19) (p = 0.32), Non-Europe 0.99 (95% CI 0.94-1.05) (p = 0.83). When the two same groups data were combined, respectively, the RRs for all studies were the same as 1.03 (95% CI 0.96-1.09) (p = 0.42) showing that there is not statistically significant in relevant stratums.
  
  
  CONCLUSIONS
  The result has showed an overall little significance for the efficacy of metronidazole combined probiotics over metronidazole alone for the treatment of BV. We need more further studies to provide enough evidence to confirm the benefits of probiotics in the treatment of BV.
authors.affiliation: Medical School of Ningbo University, Ningbo, China.
authors.forename: Hongying
authors.initials: H
authors.lastname: Tan
authors.affiliation: Department of Obstetrics and Gynecology, The Affiliated Yangming Hospital of Ningbo University, Yuyao, 315400, China.
authors.forename: Yunque
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Obstetrics and Gynecology, The Affiliated Yangming Hospital of Ningbo University, Yuyao, 315400, China.
authors.forename: Chunlin
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, The Affiliated Yangming Hospital of Ningbo University, Yuyao, 315400, China. mjt9977@126.com.
authors.forename: Jianting
authors.initials: J
authors.lastname: Ma
mesh_terms: D000282:Administration, Intravaginal; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D019936:Probiotics / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D016585:Vaginosis, Bacterial / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D008795:Metronidazole
keywords: Bacterial vaginosis; Meta-analysis; Metronidazole; Probiotics