Therapy for recurrent bacterial vaginosis: Clinical and microbiological aspects

Objective. To study the efficiency and safety and rationale for using lactic acid (femilex) in the therapy of recurrent bacterial vaginosis. Subject and methods. The open-label randomized prospective trial of the efficacy and safety of lactic acid vaginal suppositories used as part of combination therapy for recurrent bacterial vaginosis was conducted in January to December 2013. The trial enrolled 42 women who were divided into 2 groups: 1) 18 women who received metronidazole vaginal gel 0.75% as a single dose of 5.0 g for 5 days; 2) 24 women who additionally used femilex vaginal suppositories 100 mg overnight for 10 days. All the patients underwent clinical and laboratory examinations encompassing collection of complaints and medical history data, objective examination, vaginal smear microscopy, vaginal discharge pH metry, amine test, and real-time evaluation of vaginal biocenosis. Results. Prior to treatment, there were more than 4 yearly recurrences; the microbiocenosis evaluation revealed a drastic suppression of the lactobacillar flora and an increase in total bacterial contamination. The clinical and laboratory efficiency of combination therapy with metronidazole gel 0.75% + femilex for recurrent bacterial vaginosis was 95.8% and that of monotherapy with metronidazole gel 0.75% was 83.4%. Six (33.3%) and 2 (11.1%) women in the metronidazole-gel group had 3 and 4 recurrences per year, respectively; 3 (12.5%) and 2 (8.3%) women in the combination therapy group had 1 and 2 recurrences, respectively. As one year of a follow-up passed, the mean titers of Lactobacillus in Groups 1 and 2 were 2.89 lg and 5.64 lg, respectively. Evaluation of the safety and tolerability of the drugs recorded no serious adverse reactions in all the study groups.

bacterial vaginosis, metronidazole vaginal gel, lactic acid (femilex) vaginal suppositories