COMPARISON OF FREQUENCY OF SUCCESSFUL TREATMENT IN PATIENTS OF BACTERIAL VAGINOSIS TREATED WITH INTRAVAGINAL METRONIDAZOLE VERSUS INTRAVAGINAL PROBIOTICS

Abstract

Background: Bacterial vaginosis (BV) is a prevalent vaginal infection caused by an imbalance of lactobacillus-dominated flora and overgrowth of anaerobic bacteria such as Gardnerella vaginalis and Mycoplasma hominis. Standard treatment with intravaginal metronidazole often faces limitations such as recurrence, adverse effects, and poor compliance. Probiotics have emerged as a potential alternative by restoring vaginal microbiota without significant side effects. This study aimed to compare the efficacy of intravaginal probiotics and metronidazole for treating bacterial vaginosis.

Objective: To compare the frequency of successful treatment in patients with bacterial vaginosis treated with intravaginal metronidazole versus intravaginal probiotics.

Methods: This randomized controlled study was conducted over six months at the Department of Obstetrics & Gynecology, Sandeman Provincial Hospital, Quetta. A total of 66 women aged 18-35 years with BV (Nugent score ≥7) were randomly allocated into two groups. The BV-P group received intravaginal probiotics, while the BV-M group received intravaginal metronidazole. Treatment success was defined as the resolution of fishy odor and a Nugent score <4 at 30 days post-treatment. Baseline characteristics, follow-up Nugent scores, and treatment outcomes were recorded and analyzed using SPSS version 20.0.

Results: Participants had a mean age of 27.2 ± 5.3 years, with 37.9% aged 18-25 years and 62.1% aged 26-35 years. The mean disease duration was 12.8 ± 4.2 days. At baseline, both groups were comparable in age, disease duration, and Nugent scores (p > 0.05). At follow-up, the probiotics group demonstrated a significantly lower Nugent score (2.24 ± 1.50 vs. 3.79 ± 2.52, p = 0.004) and a higher success rate (90.9% vs. 60.6%, p = 0.004). Probiotics maintained superior outcomes across all subgroups.

Conclusion: Intravaginal probiotics showed significantly better efficacy than metronidazole in treating bacterial vaginosis, with improved Nugent scores and treatment success rates. Probiotics represent a viable alternative to traditional antibiotic therapy, providing better patient outcomes with minimal side effects.