Laboratory Department, The People's Hospital of Leshan, Leshan, China.
Front Cell Infect Microbiol. 2024 Oct 11;14:1402346. doi: 10.3389/fcimb.2024.1402346. eCollection 2024.
Bacterial vaginosis is a disease caused by vaginal microecology disorder, which seriously affects female health. At present, there are many drugs to treat BV, and this study aims to compare the efficacy and safety of multiple drugs for BV through a network meta-analysis (NMA).
All studies were sourced from PubMed and Embase databases from the establishment date to April 13, 2023. We evaluated the clinical cure success rate and adverse effects (abnormal increase in vaginal discharge, external genital irritation, and vulvar itching) and performed subgroup analyses of the clinical cure success rate for different modes of administration. All statistical analyses were performed using R and STATA 14.0 software for network meta-analysis.
We included 42 studies that met the criteria, involving a total of 8382 patients. Network meta-analysis results showed that metronidazole and secnidazole had a higher rate of adverse reactions than placebo (RR 7.06; 95%-CI 2.61-19.10, RR 4.03; 95%-CI 1.63-9.98), the adverse reaction rate of probiotics group was lower than that of metronidazole group (RR 0.44; 95%-CI 0.21-0.93). The clinical cure rate of oral ornidazole was better than clindamycin (RR 16.08; 95%-CI 1.72-150.47), Secnidazole (RR 8.17; 95%-CI 1.66-40.25) and probiotics. Direct meta-analysis results showed that ornidazole had a better clinical cure rate than Secnidazole (RR 1.22; 95%-CI 1.10-1.34), oral ornidazole had a better clinical cure rate than Secnidazole (RR 1.23; 95%-CI 1.11-1.36). The clinical cure rate of vaginal application of sucrose was better than metronidazole (RR 1.12; 95%-CI 1.03-1.21) and metronidazole had a lower clinical cure rate than probiotics (RR 0.68; 95%-CI 0.52-0.88).
The results of this systematic review and network meta-analysis suggest that ornidazole may be an effective alternative for the treatment of BV, and that sucrose and probiotics are potential BV treatments that need to be validated by more high-quality clinical studies in the future.
细菌性阴道病是一种由阴道微生态失调引起的疾病，严重影响女性健康。目前，有许多药物可用于治疗 BV，本研究旨在通过网络荟萃分析（NMA）比较多种药物治疗 BV 的疗效和安全性。
所有研究均来自 PubMed 和 Embase 数据库，从建立日期到 2023 年 4 月 13 日。我们评估了临床治愈率和不良反应（阴道分泌物异常增多、外阴刺激和外阴瘙痒），并对不同给药方式的临床治愈率进行了亚组分析。所有统计分析均使用 R 和 STATA 14.0 软件进行网络荟萃分析。
我们纳入了 42 项符合标准的研究，共涉及 8382 名患者。网络荟萃分析结果显示，甲硝唑和塞克硝唑的不良反应发生率高于安慰剂（RR 7.06；95%CI 2.61-19.10，RR 4.03；95%CI 1.63-9.98），益生菌组的不良反应发生率低于甲硝唑组（RR 0.44；95%CI 0.21-0.93）。口服奥硝唑的临床治愈率优于克林霉素（RR 16.08；95%CI 1.72-150.47）、塞克硝唑（RR 8.17；95%CI 1.66-40.25）和益生菌。直接荟萃分析结果表明，奥硝唑的临床治愈率优于塞克硝唑（RR 1.22；95%CI 1.10-1.34），口服奥硝唑的临床治愈率优于塞克硝唑（RR 1.23；95%CI 1.11-1.36）。阴道应用蔗糖的临床治愈率优于甲硝唑（RR 1.12；95%CI 1.03-1.21），甲硝唑的临床治愈率低于益生菌（RR 0.68；95%CI 0.52-0.88）。
本系统评价和网络荟萃分析的结果表明，奥硝唑可能是治疗 BV 的有效替代药物，而蔗糖和益生菌可能是未来需要更多高质量临床研究验证的潜在 BV 治疗方法。
