Advanced search
1 file | 231.71 KB

Antiseptics and disinfectants for the treatment of bacterial vaginosis: a systematic review

Author
Organization
Abstract
Background: The study objective was to assess the available data on efficacy and tolerability of antiseptics and disinfectants in treating bacterial vaginosis (BV). Methods: A systematic search was conducted by consulting PubMed (1966-2010), CINAHL (1982-2010), IPA (1970-2010), and the Cochrane CENTRAL databases. Clinical trials were searched for by the generic names of all antiseptics and disinfectants listed in the Anatomical Therapeutic Chemical (ATC) Classification System under the code D08A. Clinical trials were considered eligible if the efficacy of antiseptics and disinfectants in the treatment of BV was assessed in comparison to placebo or standard antibiotic treatment with metronidazole or clindamycin and if diagnosis of BV relied on standard criteria such as Amsel's and Nugent's criteria. Results: A total of 262 articles were found, of which 15 reports on clinical trials were assessed. Of these, four randomised controlled trials (RCTs) were withheld from analysis. Reasons for exclusion were primarily the lack of standard criteria to diagnose BV or to assess cure, and control treatment not involving placebo or standard antibiotic treatment. Risk of bias for the included studies was assessed with the Cochrane Collaboration's tool for assessing risk of bias. Three studies showed non-inferiority of chlorhexidine and polyhexamethylene biguanide compared to metronidazole or clindamycin. One RCT found that a single vaginal douche with hydrogen peroxide was slightly, though significantly less effective than a single oral dose of metronidazole. Conclusion: The use of antiseptics and disinfectants for the treatment of BV has been poorly studied and most studies are somehow methodologically flawed. There is insufficient evidence at present to advocate the use of these agents, although some studies suggest that some antiseptics may have equal efficacy compared to clindamycin or metronidazole. Further study is warranted with special regard to the long-term efficacy and safety of antiseptics and disinfectants for vaginal use.
Keywords
Therapy, Systematic review, Disinfectants, Antiseptics, Bacterial vaginosis, Chlorhexidine, Polyhexamethylene biguanide, Hydrogen peroxide, NONSPECIFIC VAGINITIS, VAGINAL INFECTIONS, POVIDONE-IODINE, LOCAL TREATMENT, EFFICACY, METRONIDAZOLE, CLINDAMYCIN, ETIOLOGY

Downloads

  • Antiseptics and disinfectants.pdf
    • full text
    • |
    • open access
    • |
    • PDF
    • |
    • 231.71 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Verstraelen, Hans, Rita Verhelst, Kristien Roelens, and Marleen Temmerman. 2012. “Antiseptics and Disinfectants for the Treatment of Bacterial Vaginosis: a Systematic Review.” Bmc Infectious Diseases 12.
APA
Verstraelen, H., Verhelst, R., Roelens, K., & Temmerman, M. (2012). Antiseptics and disinfectants for the treatment of bacterial vaginosis: a systematic review. BMC INFECTIOUS DISEASES, 12.
Vancouver
1.
Verstraelen H, Verhelst R, Roelens K, Temmerman M. Antiseptics and disinfectants for the treatment of bacterial vaginosis: a systematic review. BMC INFECTIOUS DISEASES. 2012;12.
MLA
Verstraelen, Hans, Rita Verhelst, Kristien Roelens, et al. “Antiseptics and Disinfectants for the Treatment of Bacterial Vaginosis: a Systematic Review.” BMC INFECTIOUS DISEASES 12 (2012): n. pag. Print.
@article{3058321,
  abstract     = {Background: The study objective was to assess the available data on efficacy and tolerability of antiseptics and disinfectants in treating bacterial vaginosis (BV). 
Methods: A systematic search was conducted by consulting PubMed (1966-2010), CINAHL (1982-2010), IPA (1970-2010), and the Cochrane CENTRAL databases. Clinical trials were searched for by the generic names of all antiseptics and disinfectants listed in the Anatomical Therapeutic Chemical (ATC) Classification System under the code D08A. Clinical trials were considered eligible if the efficacy of antiseptics and disinfectants in the treatment of BV was assessed in comparison to placebo or standard antibiotic treatment with metronidazole or clindamycin and if diagnosis of BV relied on standard criteria such as Amsel's and Nugent's criteria. 
Results: A total of 262 articles were found, of which 15 reports on clinical trials were assessed. Of these, four randomised controlled trials (RCTs) were withheld from analysis. Reasons for exclusion were primarily the lack of standard criteria to diagnose BV or to assess cure, and control treatment not involving placebo or standard antibiotic treatment. Risk of bias for the included studies was assessed with the Cochrane Collaboration's tool for assessing risk of bias. Three studies showed non-inferiority of chlorhexidine and polyhexamethylene biguanide compared to metronidazole or clindamycin. One RCT found that a single vaginal douche with hydrogen peroxide was slightly, though significantly less effective than a single oral dose of metronidazole. 
Conclusion: The use of antiseptics and disinfectants for the treatment of BV has been poorly studied and most studies are somehow methodologically flawed. There is insufficient evidence at present to advocate the use of these agents, although some studies suggest that some antiseptics may have equal efficacy compared to clindamycin or metronidazole. Further study is warranted with special regard to the long-term efficacy and safety of antiseptics and disinfectants for vaginal use.},
  articleno    = {148},
  author       = {Verstraelen, Hans and Verhelst, Rita and Roelens, Kristien and Temmerman, Marleen},
  issn         = {1471-2334},
  journal      = {BMC INFECTIOUS DISEASES},
  keyword      = {Therapy,Systematic review,Disinfectants,Antiseptics,Bacterial vaginosis,Chlorhexidine,Polyhexamethylene biguanide,Hydrogen peroxide,NONSPECIFIC VAGINITIS,VAGINAL INFECTIONS,POVIDONE-IODINE,LOCAL TREATMENT,EFFICACY,METRONIDAZOLE,CLINDAMYCIN,ETIOLOGY},
  language     = {eng},
  pages        = {8},
  title        = {Antiseptics and disinfectants for the treatment of bacterial vaginosis: a systematic review},
  url          = {http://dx.doi.org/10.1186/1471-2334-12-148},
  volume       = {12},
  year         = {2012},
}

Altmetric
View in Altmetric
Web of Science
Times cited: