Comparison of different metronidazole therapeutic regimens for bacterial vaginosis. A meta-analysis
V. I. Lugo-Miro, M. Green and L. Mazur
Department of Pediatrics, University of Texas Health Science Center, Houston.
OBJECTIVE--To evaluate the treatment of bacterial vaginosis with
metronidazole to determine if there is a therapeutic regimen that is
superior to all others with regard to cure and recurrence rates. DATA
SOURCES--Computer-assisted literature search, Medical Subject Index review,
and references cited in articles identified. STUDY SELECTION--Clinical
trials comparing different oral metronidazole regimens in which diagnostic
criteria for bacterial vaginosis and criteria to detect cure to treatment
were described. DATA EXTRACTION--Articles that met inclusion criteria were
critically appraised and those that passed were included in the analysis.
Of 52 initial articles, 10 met criteria for inclusion and passed critical
appraisal. DATA SYNTHESIS--Patients were divided in groups according to the
duration of therapy received: group A (n = 413), 2-g single dose; group B
(n = 193), 2-g single daily dose for 2 days; group C (n = 317), 5 days; and
group D (n = 280), 7 days. Cure rates on initial evaluation for the groups
were 85%, 87%, 86%, and 87%, respectively. chi 2 Contingency table analysis
showed no significant difference in cure rates among the groups (P = .78).
Only 465 of these patients were evaluated for recurrence of disease. There
was no significant difference in cure rates after 4 weeks of therapy (P =
.4). CONCLUSIONS--A 2-g single-dose metronidazole regimen is as effective
as a single daily dose given for 2 days or a 5-day course or a 7-day
course.
