Comparison of clindamycin phosphate vaginal cream with triple sulfonamide vaginal cream in the treatment of bacterial vaginosis

Background: Triple sulfonamide vaginal cream has been used to treat bacteri al vaginosis for many years. There are few studies in which triple sulfonam ide cream has been compared with newer regimens. Goal: To compare the efficacy and safety of clindamycin phosphate vaginal c ream with that of triple sulfonamide vaginal cream in the treatment of bact erial vaginosis. Study Design: In this double-blind, randomized multicenter study, nonpregna nt women 16 years of age or older with symptomatic bacterial vaginosis were assigned to receive either 2% clindamycin phosphate vaginal cream or tripl e sulfonamide vaginal cream for 7 days. Follow-up visits were conducted 5 t o 10 days and 25 to 39 days after completion of treatment. Results: Clinical cure or improvement at 25 to 39 days was noted in 55 (69. 6%) of 79 assessable participants who received clindamycin vaginal cream an d in 33 (41.8%) of 79 women who received triple sulfonamide vaginal cream ( P < 0.0001). Most of the difference between the treatment groups was noted in women with a history of bacterial vaginosis. Among women without a histo ry of bacterial vaginosis, clindamycin and triple sulfonamide creams had si milar efficacy. Evaluation of Gram-stained vaginal smears correlated with c linical outcome. Most patients in both treatment groups reported an improve ment in symptoms. No significant difference was observed between the treatm ent groups in the incidence of adverse events. Conclusion: Clindamycin 2% vaginal cream is more effective than triple sulf onamide vaginal cream in the treatment of bacterial vaginosis.