CLINICAL QUESTION

Is dequalinium (not available in the United States) noninferior to metronidazole (Flagyl) for the treatment of bacterial vaginosis?

BOTTOM LINE

The study found that dequalinium is noninferior to metronidazole for the treatment of bacterial vaginosis. Patients who used dequalinium reported better tolerability and fewer adverse events than those treated with metronidazole. (Level of Evidence = 1b)

SYNOPSIS

The recurrence rate of bacterial vaginosis within 6 months of treatment with metronidazole or clindamycin is 30% to 70%. Dequalinium is a broad-spectrum antiseptic that is effective against gram-positive and gram-negative bacteria. The investigators identified 147 women 18 years or older who were diagnosed with bacterial vaginosis using the Amsel criteria. Eligible patients randomly received dequalinium vaginal tablets, 10 mg/day for 6 days, or metronidazole oral tablets, 500 mg two times/day for 7 days. Double-dummy medication kits were used to mask patients, clinicians, and outcome assessors to group assignments. Complete follow-up occurred for 97.4% of participants at 7 to 11 days (visit 1) and 20 to 40 days (visit 2).