EFFICIENCY OF PROBIOTIC VAGINAL TAMPONS VERSUS ORAL METRONIDAZOLE IN THE TREATMENT OF BACTERIAL VAGINOSIS

Introduction: Bacterial vaginosis is defined as change in the vaginal ecology characterized by replacement of lactobacilli by a variety of bacterial flora including anaerobes. The condition is diagnosed using Amsel Criteria. Ten to fifteen percent of cases do not improve on antibiotics, which encouraged the use of probiotics. Aim: To compare between the efficiency of probiotic vaginal tampons and oral metronidazole in the treatment of bacterial vaginosis. Patients & Methods: Three hundred and three qualified cases -of which 270 case continued-were subjected to history, general, abdominal, local examination including speculum examination and investigations in the form of pH strip indictor, vaginal swab from the discharge, 10% potassium hydroxide (KOH) added to perform Whiff test and finally vaginal smear, then the patients were divided into 2 groups Group 1 consisted of 151 patients receiving oral metronidazole for one week and Group 2 received oral placebo and probiotic vaginal tampons for one week. All patients had follow-up after 10 and 30 days from the start of treatment to assess the efficacy of treatment and assess persistence or recurrence respectively and data were collected. Results: There was insignificant difference between both groups as regards age and the type of contraception used. Follow-up after 30 days showed a significant difference in the cure rate between both groups in favor of the probiotic vaginal tampons (91.8% vs. 57.8%). Conclusion: Probiotic vaginal tampons are superior to oral metronidazole in the treatment of bacterial vaginosis with the advantages of avoiding drug side effects and resistance.