MULTICENTER COMPARISON OF CLOTRIMAZOLE VAGINAL TABLETS, ORAL METRONIDAZOLE, AND VAGINAL SUPPOSITORIES CONTAINING SULFANILAMIDE, AMINACRINE HYDROCHLORIDE, AND ALLANTOIN IN THE TREATMENT OF SYMPTOMATIC TRICHOMONIASIS
L. Dubouchet et al., MULTICENTER COMPARISON OF CLOTRIMAZOLE VAGINAL TABLETS, ORAL METRONIDAZOLE, AND VAGINAL SUPPOSITORIES CONTAINING SULFANILAMIDE, AMINACRINE HYDROCHLORIDE, AND ALLANTOIN IN THE TREATMENT OF SYMPTOMATIC TRICHOMONIASIS, Sexually transmitted diseases, 24(3), 1997, pp. 156-160
Background and Objectives: Trichomonas vaginalis is a common vaginal p
athogen. Oral metronidazole is the drug of choice for the treatment of
trichomoniasis. Oral metronidazole, however, may cause unpleasant sid
e effects and is contraindicated during the first trimester of pregnan
cy, In vitro studies and preliminary clinical data have suggested that
intravaginal clotrimazole may be effective against this pathogen. Goa
ls: To compare the efficacy of clotrimazole vaginal tablets, oral metr
onidazole, and vaginal suppositories containing sulfanilamide, aminacr
ine, and allantoin (AVC suppositories) in the treatment of women with
symptomatic trichomoniasis. Study Design: In a multicenter, open-label
trial conducted in 1982 and 1983, 168 symptomatic women with microsco
pically evident vaginal trichomoniasis were randomized to receive any
of 2 g of metronidazole as a single oral dose, two 100-mg clotrimazole
vaginal tablets once a day for 7 days, or vaginal suppositories conta
ining 1.05 g of sulfanilamide, 14 mg of aminacrine hydrochloride, and
140 mg of allantoin (AVC suppositories) twice a day for 7 days. Wet mo
unts and cultures were repeated at 1 to 2 and 4 to 6 weeks after compl
etion of treatment. Results: The numbers of patients who had positive
cultures after treatment were 40/45 (88.9%) in the clotrimazole group,
35/43 (81.4%) in the AVC suppository group, and 9/45 (20%) in the met
ronidazole group (P < 0.001), All treatments were associated with a re
duction in reported symptoms. Oral metronidazole was more effective in
reducing symptoms than either of the topical preparations, Adverse ev
ents, mostly mild or moderate in severity, were reported by 7 (14.6%)
of 48 patients who had received oral metronidazole and 4 (7.8%) of 51
women who used AVC suppositories, There were no adverse events reporte
d by the 50 women who used clotrimazole vaginal tablets, Conclusions:
Oral metronidazole was more effective in eradicating T. vaginalis than
clotrimazole vaginal tablets or AVC vaginal suppositories, All three
regimens reduced symptoms; oral metronidazole was more effective in re
ducing symptoms than either topical preparation.