Metronidazole for bacterial vaginosis - A comparison of vaginal gel vs. oral therapy

OBJECTIVE: To compare the efficacy and safety of 0.75% metronidazole vagina l gel with oral metronidazole for the treatment of bacterial vaginosis (BV) . STUDY DESIGN: Non-pregnant women with BV were enrolled in a multi-center, r andomized investigator-blind treatment trial. Patients were randomly assign ed to either 0.75% metronidazole vaginal gel (5 g twice daily for five days ) or oral metronidazole (500 mg twice daily for seven days). Follow-up visi ts occured approximately two and five weeks after initiation of therapy RESULTS: BV was clinically eliminated at the first follow-up visit in 83.7% (36/43 95% Cl 72.3%-95%) of the intravaginal group and 85.1% (40/47, 95% C l 74.6-95.6%) of the oral group. At the final visit, BV was eliminated in 7 0.7% (29/41, 95% Cl 56.3-85.1%) of the intravaginal group and 71.1% (32/45, 95% Cl 57.4-84.8%) of the oral group. Significantly more patients in the o ral treatment group (51.8%) reported gastrointestinal complaints as compare d to the intravaginal treatment group (32.7%, P=.04). CONCLUSION: The efficacy of 0.75% metronidazole vaginal gel twice daily for five days in treating BV was similar to that of standard oral metronidazol e treatment and was associated with fewer gastrointestinal complaints.