The Addition of Vitamin C Vaginal Tablets to Oral Metronidazole and its Effect on the Treatment and Recurrence of Bacterial Vaginosis: A Randomized Triple-Blind Clinical Trial

Bacterial vaginosis (BV) is the most common vaginitis, which is derived from a reduction in vaginal lactobacilli and an increased growth of other anaerobic species of bacteria. Vitamin C can be effective in treatment of BV through the production of lactic acid. The aim of the present study was to determine the efficacy of adding vitamin C vaginal to metronidazole in treatment of BV.
This study was a triple-blind randomized clinical trial. The study was carried out from July 2015 to November 2015 on 160 women who referred to gynecologic clinic of Mashhad with pure BV. They randomized into intervention and control groups. The intervention group received 500 mg of oral metronidazole tablets twice a day along with 250 mg vitamin C vaginal tablets for 7 days and the control group received the same dose of oral metronidazole along with placebo for 7 days. Amsel and Nugent criteria were analyzed prior, 10 ± 3, and 30 ± 3 days after the treatment.
The cure rate, based on Amsel and Nugent criteria was 85.9% in intervention group and 52.3% in control group on day 10 ± 3 (odds ratio [OR]: 5.3, 95% CI: 2.4 to 11.6) and 87.7% in intervention group and 41.9% in control group on day 30 ± 3 (OR: 9. 8, 95% CI: 4.2 to 22.4).
According to the results, it seems that the two-drug treatment of BV with oral metronidazole and vitamin C vaginal tablets is more effective than one-drug treatment of BV by oral metronidazole for recovery and non-recurrence.