Neotran--a new double-active pessary for the treatment of vaginitis.

The common causes of vaginitis have changed in recent years. Infection with Trichomonas vaginalis is much less frequent than it used to be. The most common causes of vaginitis are candidiasis and bacterial vaginosis due to infection with mixed bacterial flora. In general practice, treatment of vaginitis is often begun before microbiological confirmation of the diagnosis is available. A vaginal pessary has been formulated to provide an effective therapy in all three forms of vaginitis mentioned above. This formulation, Neotran, is believed to be the first pessary to contain both metronidazole and miconazole. In vivo and in vitro studies showed Neotran to be effective against Candida albicans and mixed bacterial flora. Neotran was shown, in vitro, to be active against Trichomonas but, because of the current rarity of trichomonal infection in the UK, it was not possible to show its effectiveness against Trichomonas in vivo. In a general-practice clinical trial of the treatment of vaginitis in 80 patients, Neotran pessaries achieved a microbiological resolution rate of 83% in those patients who were bacteriologically evaluable and was well tolerated. Overall clinical evaluation of the patients showed the condition to be resolved in 73% of patients, improved in 21% and unchanged in 6%.