The treatment of Gardnerella vaginalis vaginosis: a randomized comparison of pivampicillin with metronidazole.

The efficacy of pivampicillin and metronidazole were compared in the treatment of Gardnerella vaginalis associated bacterial vaginosis. In a multicenter trial 86 women were given pivampicillin (P) 700 mg twice daily for 6 days and 86 women received metronidazole (M) 400 mg three times daily for 7 days. At control, 2 weeks from the start of treatment, patients in group P showed the best clinical results, 77.9% in group P vs. 64.0% in group M (p = 0.066). P showed a higher clinical efficacy than M, both in women using intra-uterine device and in patients using other forms of contraception. Negative post-treatment cultures were seen in 43% of women in group P and 64% in group M (p less than 0.002). Bacteriological cure was unrelated to disappearance of discharge, odour and itching, although it correlated significantly with a negative amine test (p less than 0.00005). Pivampicillin in the dosages used in the present investigation is a useful alternative to metronidazole therapy.