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Infectious Diseases in Obstetrics and Gynecology
Volume 4 (1996), Issue 2, Pages 66-70
Clinical Study

Comparative Study of Intravaginal Metronidazole and Triple-Sulfa Therapy for Bacterial Vaginosis

1Department of Medicine and Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
2Department of Obstetrics and Gynecology, Sinai Samaritan Medical Center, Milwaukee, WI, USA
3Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
4Department of Obstetrics and Gynecology, San Francisco General Hospital, San Francisco, CA, USA
5Department of Obstretrics and Gynecology, University of Colorado, Denver, CO, USA
6Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
7Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA
8Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
9Department of Gynecology and Obstetrics, University of Kansas School of Medicine, Kansas City, KS, USA
10Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL, USA
11Department of Obstetrics and Gynecology, SUNY Health Science Center, Stony Brook, NY, USA
12Harper Professional Building, Suite 2140, 4160 John R Street, Detroit, MI 48201, USA

Received 11 December 1995; Accepted 29 May 1996

Copyright © 1996 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective: We sought to compare the efficacy of metronidazole gel vs. triple-sulfa cream in the treatment of bacterial vaginosis (BV).

Methods: In a double-blinded study, 247 women with symptomatic BV were randomly assigned to receive either 5 g of 0.75% metronidazole gel twice daily for 5 days or triple-sulfa cream twice daily for 5 days. There were 205 (96 treated with metronidazole and 109 treated with triple-sulfa) evaluable patients to compare efficacy at the final visit. Approximately 60% of these patients had been previously treated for BV, reflecting the recurrent nature of the disease in this patient population.

Results: At the first (12–16 days) return visit, 81/103 (79%) patients in the metronidazole group were cured compared with 80/113 (71%) patients in the triple-sulfa cream group (P = 0.333). At the final (28–35 days) return visit, 63/96 (66%) in the 96 metronidazole group remained cured compared with only 51/109 (47%) in the triple-sulfa group (P = 0.02). An intent-to-treat analysis similarly showed that the cure rate with metronidazole was superior to triple-sulfa (P ≤ 0.02). The clinical diagnosis demonstrated a high correlation (88%) with the diagnosis made by an independent assessment by Gram's stain. The side effects reported by the patients using metronidazole gel were infrequent and mild and were similar to those reported with triple-sulfa.

Conclusions: Metronidazole gel is a safe, effective, and well-tolerated treatment for BV.