Journal: |
The Journal of Maternal-Fetal & Neonatal Medicine
Tylor-francis
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Abstract: |
Purpose: To compare between continuous and interrupted use of vaginal probiotic after vaginal
clindamycin cream for treatment and prevention of recurrence of bacterial vaginosis.
Methods: A double-blinded randomized controlled clinical trial, 273 women were randomly allocated
to use clindamycin 2% vaginal cream 5 g at bedtime for 7 days followed after 1 week by
continuous probiotics vaginal capsule once daily for 6weeks (n¼129) or clindamycin 2% vaginal
cream 5 g at bedtime for 7 days followed by one probiotic vaginal capsule twice a week for
6 weeks (n¼144). The initial evaluation was at 1week after cessation of probiotics treatment to
estimate the cure rates, the follow-up visits were at 1, 3, 6, and 9months from the initial visit.
The primary outcome of this study was cure rate; the secondary outcomes were the frequency
of recurrence, the presence of vaginal discharge, pH > 4.5, positive whiff test and detection of
clue cells.
Results: At the initial visit there was no significant difference in cure rate between continuous
probiotics group and interrupted probiotics group (87.4 versus 82.5%; p¼.81). There was no significant
difference between the two groups in the recurrence rate at one, three, six and
9months follow up visits (p¼.16, p¼.42, p¼.59, p¼.66). There was no significant difference
between both groups regarding vaginal discharge reduction, pH dropping, the presence of positive
whiff test and detection of clue cells at one, three, six and 9months follow up visits. Except
at 9-month visits, the differences in vaginal discharge reduction and positive whiff test were
statically significant.
Conclusions: After initial treatment of bacterial vaginosis with vaginal clindamycin cream, the
continuous use of vaginal probiotics is equally effective to short repetitive courses in terms of
cure rates and prevention of relapse.
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