Efficacy of Clindamycin Vaginal Ovule (3‐Day Treatment) vs.Clindamycin Vaginal Cream (7‐Day Treatment) in Bacterial Vaginosis

Abstract

Objective:To compare the efficacy and safety of a 3-day regimen of clindamycin vaginal ovules with a 7-day regimen of clindamycin vaginal cream for the treatment of bacterial vaginosis (BV). Methods: Women with a clinical diagnosis of BV were treated with a 3-day course of clindamycin ovules or a 7-day course of clindamycin cream administered intravaginally. Three hundred and eighty-four patients received study drug and were included in the evaluable patient population (ovule group, n = 204; cream group, n = 180). Assessments included pelvic examination and diagnostic testing. Primary efficacy endpoints were a resolution of two of three diagnostic criteria at the first follow-up visit and three of three diagnostic criteria at the second. Results: Cure rates in the evaluable patient population were similar between treatment groups: 53.7% (109/204) for the ovule group and 47.8% (85/180) for the cream group (p = 0.2471, 95% CI 4.1-16.0%). The most commonly reported medical event, vulvovaginal pruritus, had similar incidence in both treatment groups. Conclusions: A 3-day course of clindamycin vaginal ovules is as effective and well-tolerated as a 7-day course of clindamycin vaginal cream in the treatment of BV.

Bacterial Vaginosis and Correlates in Women of Reproductive Age in Thika, Kenya

“…However, a prospective study of rural women in Gambia found no association between any sexual behavior and BV. A recent Meta-analysis found the epidemiological data to be consistent with BV having a sexual mode of transmission, but additional factors were likely to contribute to the risk [20][21][22].…”

Pathogenesis, Diagnosis and Treatment of Vaginitis and Cervicitis in Clinical Practice

“…The primary regimen for the treatment of BV is oral metronidazole,500 mg twice a day for 7 days.A single 2.0-g dose of metronidazole such as used to treat trichomoniasis is less effective and is not recommended [50].Vaginal preparations containing 0.75% metronidazole gel or 2% clindamycin cream or ovules containing 100 mg od clindamycin are effective and have few systemic effects [51][52][53].Treatment failure occur fairly commonly ,presumable because normal Lactobacillus-dominated flora fails to become established after anaerobes and other components of BV flora have been reduced in number with use of antimicrobial agents [54].Recent studies has shown that persistence of G.vaginalis in biofilims on the vaginal wall may associated with treatment failure [55].…”

Sexually Transmitted Diseases Treatment Guidelines 2002

“…Alternative regimens include several tinidazole regimens (601) or clindamycin (oral or intravaginal) (602). An additional regimen includes metronidazole (750-mg extended release tablets orally once daily for 7 days); however, data on the performance of this alternative regimen are limited.…”