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Clinical Papers
Metronidazole with Lactacyd
vaginal gel in bacterial vaginosis
Authors: Ditas Cristina D. Decena,
Jennifer T. Co, Ricardo M. Manalastas Jr, Evelyn P. Palaypayon,
Christia S. Padolina, Judith M. Sison, Louella A. Dancel and
Marievi A. Lelis (2006) |
Abstract:
Aim: To
assess the efficacy and tolerability of lactic acid (Lactacyd
vaginal gel; LVG) when given as an adjunct
to metronidazole in the treatment
of bacterial vaginosis (BV) among Filipino patients.
Methods: A multicenter,
open-labeled, controlled, randomized, three-arm comparative study
on 90 women aged 18 years or over with clinically and
microbiologically proven BV.
Results:
The lactobacilli colony count significantly increased over time
in all three arms. At day 14, growth of lactobacilli was
significantly higher among patients in the lactic acid gel and
combination treatment arms. Significant reduction of malodorous
vaginal discharge (whiff test) and lowest recurrence of BV were
noted in the metronidazole plus lactic acid gel arm. Regarding
disappearance of signs of BV, there was significant decrease in the
pH level and frequency of clue cell positive patients across time
but was not significantly different across treatment groups. Only
one patient (3%, 1/60) among those who received lactic acid gel
complained of increased curd-like discharge. Six patients (10%,
6/60) who received metronidazole complained of epigastric
pain/discomfort, dizziness and dyspnea.
Conclusions:
Lactic acid gel (LVG) is safe and as efficacious as
metronidazole in the treatment of BV. There is evidence that LVG
when combined with metronidazole is superior to metronidazole alone
in promoting lactobacilli colonization. LVG as an adjunct to
metronidazole, having the least number of recurrent BV, appears to
result in better long-term treatment effect on bacterial
vaginosis.
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Treatment of Bacterial
Vaginosis with an Acid Cream: A Comparision between the Effect of
Lactate-Gel and Metronidazole
Authors: Bjőrn Andersch, Lars
Forssman, Knut Lincoln, Per Torstensson
(1986) |
Abstract:
Bacteriological isolation of anaerobes, Gardnerella and
lactobacilli was carried out in a group of 62 women with the
diagnosis bacterial vaginosis and 42 control women. Lactobacilli
were the predominant organisms in the control group whereas
anaerobes dominated the flora in bacterial vaginosis patients.
Lactate-gel (pH 3.5, 5ml) inserted into the vagina daily for 7 days
is as effective as oral metronidazole, 500 mg twice daily for 7
days. The women in both groups became symptom-free and objectively
improved. Anaerobes were significantly reduced (p <0.0001> in
both groups after 1-week treatment but Gardnerella was not
significantly reduced. As bacterial vaginosis is generally looked
upon as a mild noninflammatory condition lactate-gel seems to be an
ideal treatment for this disease.
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Bacterial Vaginosis and the
Effect of Intermittent Prophylactic Treatment with an Acid Lactate
Gel
Authors: Bjőrn Andersch, Ditte
Lindell, Ingrid Dahlen, Åke Brandberg
(1990) |
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Abstract:
Intermittent treatment with an acid lactate gel (Lactal,
ACO, Sweden) reduced symptoms of bacterial vaginosis (BV) and
promoted the reestablishment of the normal vaginal flora of
lactobacilli. Forty-two women seriously affected by recurrent BV
were initially given acid gel (lactate gel, pH 3.8, 5ml) to be
inserted in to the vagina daily for 7 consecutive days. Thereafter
they entered into a double blind clincal trial and were treated
prophylactically 3 days monthly for 6 months with either lactate
gel or a placebo gel. Women treated with the lactate gel were
clinically improved, i.e. no signs of BV in 88% compared to 10% in
the placebo group (p <0.001). The vaginal lactobacilli flora was
reestablished in 83% of the lactate group and in 16% of the placebo
group. Local intermittent application of lactate gel was found to
be free of side effects and is a preferable alternative to repeated
treatments with antibiotics in patients with recurrent BV.
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Treatment of Bacterial
Vaginosis in Pregnancy with a Lactate Gel
Authors: Elisabet Holst, åke
Brandberg (1990) |
Abstract:
10 pregnant women with bacterial vaginosis were treated
vaginally with a low-pH lactate gel intermittently during 6 weeks.
Reappearance of a lactobacillus-dominated vaginal flora was
observed after a few days treatment in all patients. All women
experienced a subjective disappearance of abnormal vaginal
discharge and maladour. This local treatment restores the normal
vaginal acidity and facilitates recolonization with lactobacilli.
It may be preferable to oral antimicrobial therapy, especially
during pregnancy.
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