Oral metronidazole vs. metrogel vaginal for treating bacterial vaginosis -Cost-effectiveness evaluation

OBJECTIVE: To compare the cost-effectiveness of metronidazole versus Metrog el Vaginal((R)) in the treatment of bacterial vaginosis. STUDY DESIGN: Sixty consecutive patients with a clinical diagnosis of bacte rial vaginosis were randomly assigned prospectively into ei ther the metron idazole, 500 mg (twice daily for seven days by mouth) or Metrogel Vaginal(( R)) (one applicator twice daily for five days) treatment group. The study p atients were aged 18-30 years, without other medical problems. The patients proceeded with outpatient therapy and returned 7-10 days after the complet ion of treatment for reevaluation. During the study, patients refrained fro m sexual relations, avoided alcohol and drugs, and avoided all medication T he physician evaluated the patients for bacterial vaginosis through standar d wet preparation, whiff test and pH testing prior to and after treatment. The patients were randomized by a nurse and were blinded for study purposes to the evaluating physician. RESULTS: Successful treatment outcomes for bacterial vaginosis occurred in 27 and 28 patients for Metrogel Vaginal((R)) and metronidazole, respectivel y, out of the original 30 patients in each study group. All patients in-tro duced into the study completed the study without difficulty. No significant complications were found in either treatment group. Three patients treated with metronidazole experienced nausea during the treatment interval. The e ntire cost of treatment was $19.71 and $1.51 for Metrogel Vaginal((R)) and metronidazole, respectively. CONCLUSION: The most cost-effective treatment for bacterial vaginosis was g eneric metronidazole. While the use of the move expensive Metrogel Vaginal( (R)) may be reasonable for patients experiencing side effects of oral metro nidazole, most patients should be treated with the less expensive generic m etronidazole.