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Treatment considerations for bacterial vaginosis and the risk of recurrence.
J Womens Health (Larchmt). 2009 Dec; 18(12):1997-2004.JW

Abstract

BACKGROUND

Recommended regimens for the treatment of bacterial vaginosis (BV) have similar efficacy; thus, the choice of treatment should consider additional factors such as risk of BV recurrence and side effect profile. The purpose of this study was to investigate BV recurrence rates and rates of acquiring vulvovaginal candidiasis (VVC) after different BV treatments in a commercially insured population.

METHODS

Private administrative insurance claims from 2004 to 2006 were used. Study subjects were continuously enrolled females 12-50 years of age who filled prescriptions for BV treatment (n=32,268). The four BV treatments (single-dose clindamycin vaginal cream (2%), multiple-dose clindamycin vaginal regimens, vaginal metronidazole, and oral metronidazole) were compared for rates of recurrent BV and VVC after treatment using multivariate analyses. Covariates included sociodemographic and clinical characteristics.

RESULTS

Overall, the rate of BV recurrence (2.7%), and VVC posttreatment (2.9%) were low. Women who were treated with single-dose clindamycin vaginal cream (2%) showed no significant difference from women treated with oral metronidazole in the likelihood of BV recurrence. However, women who received other vaginal treatments were significantly more likely to experience BV recurrence compared with women who received oral metronidazole (p<0.01). Moreover, women who were treated with single-dose clindamycin vaginal cream (2%) and vaginal metronidazole were significantly less likely to have VVC compared with those treated with oral metronidazole (p<0.01).

CONCLUSIONS

This study suggests that single-dose clindamycin vaginal cream (2%) may be a good alternative to oral metronidazole for the treatment of BV, given the low rates of recurrence and subsequent VVC demonstrated in this analysis.

Links

Publisher Full Text

Authors+Show Affiliations

Chen JY
Health Benchmarks, Inc., IMS Health, Woodland Hills, California 91367, USA. judy.chen@us.imshealth.com
Tian H
No affiliation info available
Beigi RH
No affiliation info available

MeSH

Administration, IntravaginalAdministration, OralAdolescentAdultAnti-Bacterial AgentsCandidiasis, VulvovaginalClindamycinDrug Administration ScheduleFemaleHumansMetronidazoleMiddle AgedRisk FactorsSecondary PreventionTreatment OutcomeUnited StatesVaginaVaginosis, BacterialWomen's HealthYoung Adult

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20044862

Citation

Chen, Judy Y., et al. "Treatment Considerations for Bacterial Vaginosis and the Risk of Recurrence." Journal of Women's Health (2002), vol. 18, no. 12, 2009, pp. 1997-2004.
Chen JY, Tian H, Beigi RH. Treatment considerations for bacterial vaginosis and the risk of recurrence. J Womens Health (Larchmt). 2009;18(12):1997-2004.
Chen, J. Y., Tian, H., & Beigi, R. H. (2009). Treatment considerations for bacterial vaginosis and the risk of recurrence. Journal of Women's Health (2002), 18(12), 1997-2004. https://doi.org/10.1089/jwh.2008.1088
Chen JY, Tian H, Beigi RH. Treatment Considerations for Bacterial Vaginosis and the Risk of Recurrence. J Womens Health (Larchmt). 2009;18(12):1997-2004. PubMed PMID: 20044862.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment considerations for bacterial vaginosis and the risk of recurrence. AU - Chen,Judy Y, AU - Tian,Haijun, AU - Beigi,Richard H, PY - 2010/1/5/entrez PY - 2010/1/5/pubmed PY - 2010/3/30/medline SP - 1997 EP - 2004 JF - Journal of women's health (2002) JO - J Womens Health (Larchmt) VL - 18 IS - 12 N2 - BACKGROUND: Recommended regimens for the treatment of bacterial vaginosis (BV) have similar efficacy; thus, the choice of treatment should consider additional factors such as risk of BV recurrence and side effect profile. The purpose of this study was to investigate BV recurrence rates and rates of acquiring vulvovaginal candidiasis (VVC) after different BV treatments in a commercially insured population. METHODS: Private administrative insurance claims from 2004 to 2006 were used. Study subjects were continuously enrolled females 12-50 years of age who filled prescriptions for BV treatment (n=32,268). The four BV treatments (single-dose clindamycin vaginal cream (2%), multiple-dose clindamycin vaginal regimens, vaginal metronidazole, and oral metronidazole) were compared for rates of recurrent BV and VVC after treatment using multivariate analyses. Covariates included sociodemographic and clinical characteristics. RESULTS: Overall, the rate of BV recurrence (2.7%), and VVC posttreatment (2.9%) were low. Women who were treated with single-dose clindamycin vaginal cream (2%) showed no significant difference from women treated with oral metronidazole in the likelihood of BV recurrence. However, women who received other vaginal treatments were significantly more likely to experience BV recurrence compared with women who received oral metronidazole (p<0.01). Moreover, women who were treated with single-dose clindamycin vaginal cream (2%) and vaginal metronidazole were significantly less likely to have VVC compared with those treated with oral metronidazole (p<0.01). CONCLUSIONS: This study suggests that single-dose clindamycin vaginal cream (2%) may be a good alternative to oral metronidazole for the treatment of BV, given the low rates of recurrence and subsequent VVC demonstrated in this analysis. SN - 1931-843X UR - https://www.unboundmedicine.com/medline/citation/20044862/Treatment_considerations_for_bacterial_vaginosis_and_the_risk_of_recurrence_ L2 - https://www.liebertpub.com/doi/10.1089/jwh.2008.1088?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -