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Obstetrics & Gynecology 1993;82:405-410
© 1993 by The American College of Obstetricians and Gynecologists
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Efficacy of Clindamycin Vaginal Cream Versus Oral Metronidazole in the Treatment of Bacterial Vaginosis

FRITZ FISCHBACH, MD, EIKO E. PETERSEN, MD, ERNST R. WEISSENBACHER, MD, JOACHIM MARTIUS, MD, J. HOSMANN, MD and HO MAYER, MD

From the Frauenklinik und Poliklinik der TU München, Klinikum r.d. lsar, Germany; the Universitätsfrauenklinik Freiburg, Germany; the Frauenklinik der LMU München, Klinikum Grosshadern, Germany; the Universitätsfrauenklinik Würzburg, Germany; the Universitätsfrauenklinik Wien, Austria; the Universitätsfrauenklinik Graz, Austria; and the Universitätsfrauenklinik Basel, Switzerland

Abstract

Objective: To compare the efficacy and tolerance with 2% clindamycin vaginal cream versus oral metronidazole for the treatment of bacterial vaginosis.

Methods: This was a multicenter, randomized, double-blind study in which patients were randomly assigned to one of the following two regimens in a 1:1 ratio: clindamycin phosphate vaginal cream 2% (5 g intravaginally at bedtime for 7 days) plus two placebo capsules (twice a day for 7 days) or metronidazole 500 mg (two 250-mg capsules orally twice a day for 7 days) plus placebo vaginal cream (5 g intravaginally at bedtime for 7 days). The patients were seen for follow-up at 5-10 days and 25-39 days after completion of therapy.

Results: Seven investigators, four in Germany, two in Austria, and one in Switzerland, enrolled 407 patients. Four patients never received either protocol drug, leaving 403 evaluable for safety. Two hundred thirty-four patients were evaluable for efficacy. The analysis for all evaluable patients showed no significant difference between treatment groups. The cure or improvement rate at 1 month after therapy was 83% in the clindamycin group versus 78% in the metronidazole group. The incidence of drug-related adverse medical events was approximately 12% in both groups.

Conclusions: Oral metronidazole and intravaginal clindamycin cream had a similar efficacy of 78 to 83%. Both drugs were tolerated, with vaginal candidiasis developing in 8.5 and 4.7% of the patients in the clindamycin and metronidazole groups, respectively.




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