Effectiveness and tolerability of lactic acid vaginal gel compared to oral metronidazole in the treatment of acute symptomatic bacterial vaginosis: a multicenter, randomized-controlled, head-to-head pilot study
2025

Lactic Acid Gel vs. Metronidazole for Bacterial Vaginosis Treatment

Sample size: 32 publication 10 minutes Evidence: moderate

Author Information

Author(s): Fiona Tidbury, Grégory Brülhart, Gabriela Müller, Elena Pavicic, Susanna Weidlinger, Gerrit Eichner, Michael von Wolff, Petra Stute

Primary Institution: University Clinic of Bern

Hypothesis

Is lactic acid vaginal gel as effective as oral metronidazole for treating acute bacterial vaginosis?

Conclusion

Lactic acid vaginal gel was well tolerated and showed mixed results as a treatment for acute bacterial vaginosis.

Supporting Evidence

  • 60% of patients using lactic acid gel were considered cured after three weeks based on Amsel criteria.
  • 14 out of 14 patients in the metronidazole group were cured after three weeks.
  • The lactic acid gel group had a recurrence rate of 37.5% compared to 14.3% in the metronidazole group.

Takeaway

This study looked at two treatments for a common vaginal infection. One was a gel, and the other was a pill. The gel was okay but not as good as the pill for curing the infection.

Methodology

32 women with acute bacterial vaginosis were randomly assigned to receive either lactic acid vaginal gel or oral metronidazole, with various assessments at multiple follow-up points.

Potential Biases

The lack of masking could introduce bias in treatment assignment and reporting.

Limitations

The study lacked masking, had a low retention rate, and the short-term efficacy was only assessed at three weeks.

Participant Demographics

All participants were women aged 18 and older with acute symptomatic bacterial vaginosis.

Statistical Information

P-Value

0.020

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/s12905-024-03513-1

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