Oral lactobacillus and metronidazole in the management of bacterial vaginosis in pregnant women: A double-blind randomized controlled trial.
- Author:
Lilli Mae TEODORE-COLE
;
Fransiska MOCHTAR
;
Ronaldo R SANTOS
;
Jennifer T CO
- Publication Type:Journal Article, Original
- Keywords:
Preterm LaborBacterial VaginosisDouble-blind Randomized Controlled Trial
- MeSH:
Lactobacillus;
Women;
Metronidazole;
Obstetric Labor, Premature;
Bacterial Infections;
Vaginitis;
Pregnant Women;
Vaginosis Bacterial
- From:
Philippine Journal of Obstetrics and Gynecology
2007;31(4):197-202
- CountryPhilippines
- Language:English
-
Abstract:
Objective: This study was designed to determine the efficacy of combined metronidazole and lactobacillus tablet in the treatment of bacterial vaginosis among pregnant women. Methodology: Fifty pregnant patients with bacterial vaginosis diagnosed by Nugent Criteria where included and randomized into group A, metronidazole and placebo and group B, metronidazole and lactobacillus tablet. The study utilized a block randomization where the sequence of the treatment assignment was randomly selected based on a set of random numbers generated. Group A received metronidazole 500 mg tab BID and placebo tablet once a day for 7 days. Group B received metronidazole 500 mg BID and lactobacillus tablet (50 million unit of lactobacillus strain per tablet) once a day for 7 days. Gram stain of vaginal discharge was done one week after the treatment, and then repeated every two weeks until delivery in both arms. Maternal and fetal complications such as premature rupture of membranes, preterm labor, chorioamnionitis were recorded. If therapy failed, patients were retreated with clindamycin 300 mg BID for one week. Adverse reactions to the drug were likewise recorded. Result: The mean Nugent score reduction in the metronidazoie and lactobacillus group was significantly larger than the mean decrease in the metronidazole and placebo groups (p-value=0.019). The result was higher after two weeks of treatment. (p-value=0.012 < 0.019).There is no significant difference in pregnancy and fetal outcome between the two groups. The metronidazole and placebo groups experienced recurrence of bacterial vaginosis of 24 percent while no patient in the metronidazole and lactobacillus groups experienced recurrence (p-value=0.022) after 4 weeks. Conclusion: Based on the findings from this study, Metronidazole combined with lactobacillus is a better treatment for bacterial vaginosis than metronidazole alone. (Author)
