Abstract
This was a clinical trial study that aimed to investigate the efficacy of vaginal chlorhexidine gel in the treatment of vulvovaginal candidiasis, bacterial vaginosis, and nonspecific vaginitis. The study population included patients who complained of vaginal discharge and presented to our University Gynecology Clinic. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software. The student t-test and Mann-Whitney U test were used to analyze the quantitative and ordinal data, respectively. In order to analyze the qualitative data, the Chi-square or Fischer’s exact tests were used. The mean satisfaction score in the vulvovaginal candidiasis patients who received chlorhexiine vaginal gel was 9.06 and 8.29 in the patients who received clotrimazole vaginal cream. The Mann-Whitney test did not show a statistically significant difference between mean scores of VAS in these two groups with vulvovaginal candidiasis (P=0.027). Among the patients with bacterial vaginosis, the mean satisfaction score was 8.91 in the chlorhexidine vaginal gel group and 8.72 in the metronidazole tablet group (P=0.607). In the nonspecific vaginitis group, the mean satisfaction score was 8.83 in the chlorhexidine vaginal gel group and 9.17 in the combination group (metronidazole + clotrimazole vaginal cream)(P=0.401). The highest mean visual analog scale score (VAS) score was documented in the combination therapy group. We found that chlorhexidine vaginal gel is a more effective method for the treatment and improvement of vaginal infections. The benefits of chlorhexidine gel have a positive therapeutic effect as a single drug in nonspecific vaginitis, rather than simultaneous administration of two agents.
Highlights
Vaginal bacterial infections have gained attention due to the increased prevalence of urinary tract infections (UTIs) and sexually transmitted diseases (STDs) [1]
The study population consisted of female patients who presented to our University Gynecology Clinic complaining of vaginal discharge
Findings regarding the diagnostic criteria for Bacterial vaginosis (BV) showed no significant difference regarding the Whiff test (P=0.30), Nitrazine test (P=0.573), malodorous discharge (P=0.618) and clue cells (P=1.000) between the chlorhexidine vaginal gel and oral metronidazole groups
Summary
Vaginal bacterial infections have gained attention due to the increased prevalence of urinary tract infections (UTIs) and sexually transmitted diseases (STDs) [1]. Bacterial infections are among the most common causes of vaginal discharge during the reproductive age [2]. It is estimated that about 75% of women develop VVC at least once in their lifetime This vaginitis involves increased colonization and exacerbation of Candida (85% to 90%, Candida albicans) invasion to the epithelial cells of the lower genital tract [4]. There is a type of vaginitis that does not meet the criteria presented above but involves a combination of some of the features of VVC and BV.
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