The effectiveness of intravaginal vitamin C versus placebo for the treatment of bacterial vaginosis: a systematic review protocol.

Abstract

REVIEW QUESTION / OBJECTIVE The objective of this review is to identify the effectiveness of intravaginal vitamin C compared to intravaginal placebo for the treatment of adult women with bacterial vaginosis. INCLUSION CRITERIA Types of participants This review will consider studies that include women (ages 15 years and older) with bacterial vaginosis, excluding women with human immunodeficiency virus and/or those who were concomitantly using antibiotics. These women will be excluded in order to determine factors that may be exclusive to the disease process. Types of intervention(s)/phenomena of interest This review will consider studies that compare treatment regimens of intravaginal vitamin C (ascorbic acid) with placebo. Types of outcomes This review will consider studies that include the following outcome measures: cure rate defined by the presence and/or absence of Amsel criteria or Nugent criteria. Diagnosis using Amsel criteria requires at least three out of four criteria: homogeneous, thin, grayish-white discharge; vaginal pH>4.5; positive fishy odor (Whiff-amine test); and/or presence of clue cells on wet mount. Diagnosis using Nugent criteria requires laboratory examination of the number of lactobacilli, Gardnerella bacteroides, and gram-negative bacilli present. A Nugent score of 7 or greater is positive for Bacterial vaginosis . Any follow-up time will be considered in the review. Secondary outcomes and adverse events are beyond the scope of this review and, therefore, will not be considered as part of the outcomes inclusion criteria.