Effectiveness and tolerability of lactic acid vaginal gel compared to oral metronidazole in the treatment of acute symptomatic bacterial vaginosis: a multicenter, randomized-controlled, head-to-head pilot study
Abstract Background Bacterial vaginosis (BV) is a prevalent vaginal condition among reproductive-age women, characterized by off-white, thin vaginal discharge with a fishy odor. It increases susceptibility to sexually transmitted diseases (STDs) and pelvic inflammatory disease (PID). BV involves a s...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | BMC Women's Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12905-024-03513-1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841544276114145280 |
|---|---|
| author | Fiona Tidbury Grégory Brülhart Gabriela Müller Elena Pavicic Susanna Weidlinger Gerrit Eichner Michael von Wolff Petra Stute |
| author_facet | Fiona Tidbury Grégory Brülhart Gabriela Müller Elena Pavicic Susanna Weidlinger Gerrit Eichner Michael von Wolff Petra Stute |
| author_sort | Fiona Tidbury |
| collection | DOAJ |
| description | Abstract Background Bacterial vaginosis (BV) is a prevalent vaginal condition among reproductive-age women, characterized by off-white, thin vaginal discharge with a fishy odor. It increases susceptibility to sexually transmitted diseases (STDs) and pelvic inflammatory disease (PID). BV involves a shift in vaginal microbiota, with reduced lactobacilli and increased anaerobic bacteria. Standard treatment with oral metronidazole has been shown to have a limited long-term efficacy, possibly due to biofilm persistence. Alternative treatments, such as lactic acid vaginal gel, aim to restore vaginal pH and lactobacilli. This pilot study compares the efficacy and tolerability of lactic acid gel to standard oral metronidazole for acute BV treatment in non-pregnant women. Methods A total of 32 women with acute BV were recruited and assigned to either the treatment group (n = 16) where they applied a lactic acid vaginal gel for 12 days, or the control group (n = 16) which received 500 mg oral metronidazole twice daily for seven days. A number of objective and subjective parameters including the Amsel score, the Nugent score and a subjective symptom score were recorded at day 0, three weeks, three months, and six months after the study start. Results In the short-term, lactic acid vaginal gel showed inferior clinical (Amsel criteria) and microbiological (Nugent score) cure rates compared to metronidazole. However, it performed equally well regarding subjective symptom improvement and BV recurrence prevention after up to six months. Conclusion Lactic acid vaginal gel was generally very well tolerated and showed mixed but promising results as a stand-alone treatment for acute BV. Trial registration number NCT02042287 (22.01.2014). |
| format | Article |
| id | doaj-art-48d9f8dad5aa421a812fd18a8a358cb6 |
| institution | Kabale University |
| issn | 1472-6874 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj-art-48d9f8dad5aa421a812fd18a8a358cb62025-01-12T12:38:07ZengBMCBMC Women's Health1472-68742025-01-012511910.1186/s12905-024-03513-1Effectiveness and tolerability of lactic acid vaginal gel compared to oral metronidazole in the treatment of acute symptomatic bacterial vaginosis: a multicenter, randomized-controlled, head-to-head pilot studyFiona Tidbury0Grégory Brülhart1Gabriela Müller2Elena Pavicic3Susanna Weidlinger4Gerrit Eichner5Michael von Wolff6Petra Stute7Department of Obstetrics and Gynecology, University Clinic of BernPrivate Practice for GynecologyPrivate Practice for GynecologyDepartment of Obstetrics and Gynecology, University Clinic of BernDepartment of Obstetrics and Gynecology, University Clinic of BernMathematical Institute, Justus-Liebig University of GiessenDepartment of Obstetrics and Gynecology, University Clinic of BernDepartment of Obstetrics and Gynecology, University Clinic of BernAbstract Background Bacterial vaginosis (BV) is a prevalent vaginal condition among reproductive-age women, characterized by off-white, thin vaginal discharge with a fishy odor. It increases susceptibility to sexually transmitted diseases (STDs) and pelvic inflammatory disease (PID). BV involves a shift in vaginal microbiota, with reduced lactobacilli and increased anaerobic bacteria. Standard treatment with oral metronidazole has been shown to have a limited long-term efficacy, possibly due to biofilm persistence. Alternative treatments, such as lactic acid vaginal gel, aim to restore vaginal pH and lactobacilli. This pilot study compares the efficacy and tolerability of lactic acid gel to standard oral metronidazole for acute BV treatment in non-pregnant women. Methods A total of 32 women with acute BV were recruited and assigned to either the treatment group (n = 16) where they applied a lactic acid vaginal gel for 12 days, or the control group (n = 16) which received 500 mg oral metronidazole twice daily for seven days. A number of objective and subjective parameters including the Amsel score, the Nugent score and a subjective symptom score were recorded at day 0, three weeks, three months, and six months after the study start. Results In the short-term, lactic acid vaginal gel showed inferior clinical (Amsel criteria) and microbiological (Nugent score) cure rates compared to metronidazole. However, it performed equally well regarding subjective symptom improvement and BV recurrence prevention after up to six months. Conclusion Lactic acid vaginal gel was generally very well tolerated and showed mixed but promising results as a stand-alone treatment for acute BV. Trial registration number NCT02042287 (22.01.2014).https://doi.org/10.1186/s12905-024-03513-1Bacterial vaginosisMetronidazoleRandomized controlled trialsLactic acidVaginal microbiome |
| spellingShingle | Fiona Tidbury Grégory Brülhart Gabriela Müller Elena Pavicic Susanna Weidlinger Gerrit Eichner Michael von Wolff Petra Stute Effectiveness and tolerability of lactic acid vaginal gel compared to oral metronidazole in the treatment of acute symptomatic bacterial vaginosis: a multicenter, randomized-controlled, head-to-head pilot study BMC Women's Health Bacterial vaginosis Metronidazole Randomized controlled trials Lactic acid Vaginal microbiome |
| title | Effectiveness and tolerability of lactic acid vaginal gel compared to oral metronidazole in the treatment of acute symptomatic bacterial vaginosis: a multicenter, randomized-controlled, head-to-head pilot study |
| title_full | Effectiveness and tolerability of lactic acid vaginal gel compared to oral metronidazole in the treatment of acute symptomatic bacterial vaginosis: a multicenter, randomized-controlled, head-to-head pilot study |
| title_fullStr | Effectiveness and tolerability of lactic acid vaginal gel compared to oral metronidazole in the treatment of acute symptomatic bacterial vaginosis: a multicenter, randomized-controlled, head-to-head pilot study |
| title_full_unstemmed | Effectiveness and tolerability of lactic acid vaginal gel compared to oral metronidazole in the treatment of acute symptomatic bacterial vaginosis: a multicenter, randomized-controlled, head-to-head pilot study |
| title_short | Effectiveness and tolerability of lactic acid vaginal gel compared to oral metronidazole in the treatment of acute symptomatic bacterial vaginosis: a multicenter, randomized-controlled, head-to-head pilot study |
| title_sort | effectiveness and tolerability of lactic acid vaginal gel compared to oral metronidazole in the treatment of acute symptomatic bacterial vaginosis a multicenter randomized controlled head to head pilot study |
| topic | Bacterial vaginosis Metronidazole Randomized controlled trials Lactic acid Vaginal microbiome |
| url | https://doi.org/10.1186/s12905-024-03513-1 |
| work_keys_str_mv | AT fionatidbury effectivenessandtolerabilityoflacticacidvaginalgelcomparedtooralmetronidazoleinthetreatmentofacutesymptomaticbacterialvaginosisamulticenterrandomizedcontrolledheadtoheadpilotstudy AT gregorybrulhart effectivenessandtolerabilityoflacticacidvaginalgelcomparedtooralmetronidazoleinthetreatmentofacutesymptomaticbacterialvaginosisamulticenterrandomizedcontrolledheadtoheadpilotstudy AT gabrielamuller effectivenessandtolerabilityoflacticacidvaginalgelcomparedtooralmetronidazoleinthetreatmentofacutesymptomaticbacterialvaginosisamulticenterrandomizedcontrolledheadtoheadpilotstudy AT elenapavicic effectivenessandtolerabilityoflacticacidvaginalgelcomparedtooralmetronidazoleinthetreatmentofacutesymptomaticbacterialvaginosisamulticenterrandomizedcontrolledheadtoheadpilotstudy AT susannaweidlinger effectivenessandtolerabilityoflacticacidvaginalgelcomparedtooralmetronidazoleinthetreatmentofacutesymptomaticbacterialvaginosisamulticenterrandomizedcontrolledheadtoheadpilotstudy AT gerriteichner effectivenessandtolerabilityoflacticacidvaginalgelcomparedtooralmetronidazoleinthetreatmentofacutesymptomaticbacterialvaginosisamulticenterrandomizedcontrolledheadtoheadpilotstudy AT michaelvonwolff effectivenessandtolerabilityoflacticacidvaginalgelcomparedtooralmetronidazoleinthetreatmentofacutesymptomaticbacterialvaginosisamulticenterrandomizedcontrolledheadtoheadpilotstudy AT petrastute effectivenessandtolerabilityoflacticacidvaginalgelcomparedtooralmetronidazoleinthetreatmentofacutesymptomaticbacterialvaginosisamulticenterrandomizedcontrolledheadtoheadpilotstudy |