Health Benchmarks, Inc., IMS Health, Woodland Hills, California 91367, USA.
J Womens Health (Larchmt). 2009 Dec;18(12):1997-2004. doi: 10.1089/jwh.2008.1088.
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.
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.
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).
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.
细菌性阴道病（BV）的推荐治疗方案具有相似的疗效；因此，治疗选择应考虑其他因素，如 BV 复发的风险和副作用特征。本研究旨在调查不同 BV 治疗后复发率和获得外阴阴道念珠菌病（VVC）的发生率。
使用 2004 年至 2006 年私人管理的保险索赔数据。研究对象为连续入组的年龄在 12-50 岁之间的女性，她们开具了 BV 治疗处方（n=32268）。使用多变量分析比较了单剂量克林霉素阴道乳膏（2%）、多剂量克林霉素阴道方案、阴道甲硝唑和口服甲硝唑四种 BV 治疗方法治疗后复发 BV 和 VVC 的发生率。协变量包括社会人口统计学和临床特征。
总体而言，BV 复发率（2.7%）和治疗后 VVC 发生率（2.9%）较低。接受单剂量克林霉素阴道乳膏（2%）治疗的女性与接受口服甲硝唑治疗的女性在 BV 复发的可能性方面没有显著差异。然而，与接受口服甲硝唑治疗的女性相比，接受其他阴道治疗的女性复发 BV 的可能性显著更高（p<0.01）。此外，与接受口服甲硝唑治疗的女性相比，接受单剂量克林霉素阴道乳膏（2%）和阴道甲硝唑治疗的女性发生 VVC 的可能性显著降低（p<0.01）。
本研究表明，鉴于本分析中显示的低复发率和随后发生 VVC 的可能性，单剂量克林霉素阴道乳膏（2%）可能是替代口服甲硝唑治疗 BV 的一种较好选择。
