Efficacy of metronidazole and lactobacillus in the treatment of bacterial vaginosis- A comparative study

Introduction: Bacterial vaginosis (BV) is a well-known lower reproductive tract disorder occurred due to the replacement of normal vaginal flora such as lactobacillus species with another anaerobic microbial flora. Metronidazole is the primary therapeutic choice with 70% recovery rate. Aim: To assess the efficacy of Metronidazole and lactobacillus in the management of bacterial vaginosis. Materials and Methods: A total 140 cases diagnosed with bacterial vaginosis, following Nugent's scoring system and Amsel's criteria were recruited. Based on the drug administered, cases were divided in to 2 groups i.e. group 1 medicated with lactobacillus 1 bd capsule for one month then 1 od for preceding month and group 2 medicated orally with metronidazole 400mg bd for one week. Results: Vaginal pH was recorded <5> 5.5 in 22 cases. Saline mount examination showed clue cells in 88.5% cases, complete absence of clue cells in 7.8% cases and clue cells in combination with pus cells in 3.5% cases. Positive whiff-amine test was observed in 95.7% cases. Conclusion: Comparison based on Amsel criteria showed good therapeutic benefits was noted at the end of 1st week, 1st month. At the end of 3rd month and 6th month benefits were gradually decreased. Comparison by Nugent's scoring system showed good response rate was gradually decreased at the end of 1st week, 1st month and 3rd month in both the study groups. Whereas at the end of 6th month, therapeutic response was gradually decreased in both groups. Recurrence was seen in 8.5% cases of group 1 at the end of 6th month, no recurrence was seen in group2.