A comparative study of oral single dose of metronidazole, tinidazole, secnidazole and ornidazole in bacterial vaginosis

Abstract

Objective:To compare the cure rates of oral single dose of metronidazole (2 g), tinidazole (2 g), secnidazole (2 g), and ornidazole (1.5 g) in cases of bacterial vaginosis.Materials and Methods:This was a prospective, comparative, randomized clinical trial on 344 Indian women (86 women in each group) who attended a gynecology outpatient department with complaint of abnormal vaginal discharge or who had abnormal vaginal discharge on Gynecological examination but they did not complaint of it. For diagnosis and cure rate of bacterial vaginosis, Amsel's criteria were used. Statistical analysis was done by Chi-square test of proportions. The cure rate was compared considering metronidazole cure rate as gold standard.Results:At 1 week, the cure rate of tinidazole and ornidazole was 100% and at 4 weeks, it was 97.7% for both drugs (P<0.001). Secnidazole had cure rate of 80.2% at 4 weeks (P=NS). Metronidazole showed a cure rate of 77.9% at 4 weeks, which is the lowest of all four drugs.Conclusion:Tinidazole and ornidazole have better cure rate as compared to metronidazole in cases of bacterial vaginosis.

Susceptibility of bacterial vaginosis (BV)-associated bacteria to secnidazole compared to metronidazole, tinidazole and clindamycin

“…Secnidazole, a second-generation 5-nitroimidazole, has a longer half-life than both metronidazole and tinidazole (~20 vs ~8 vs ~14 hours) [16] and therefore has the potential of becoming a suitable single oral dose to treat women with BV. Outside of the United States, secnidazole is used not only to treat BV but also a variety of other infections including trichomoniasis, giardiasis and amoebiasis [17, 18].…”

Randomized, double-blind, comparative study of oral metronidazole and tinidazole in treatment of bacterial vaginosis

“…[11] Considering 10% lost to follow-up cases, a total sample size was 120. Data were analyzed by Chi-square test and Student's t -test using SPSS statistics for windows, version 17.0.…”

“…[8] Metronidazole administered either orally or topically according to multiple dose regimen has long been established as a standard treatment of BV, with 77.9% cure rate. [91011] However, necessity to administer the drug for longer duration potentially reduces compliance, thus increasing the risk of incomplete cure and recurrence of BV. [12]…”

Single dose metronidazole, tinidazole and ornidazole in the treatment of bacterial vaginosis - a comparative study

“…Cure rates of both the drugs are approximately 96-97%. 10,11 Bacterial vaginosis is the most common cause of vaginal discharge and asymptomatic women are less likely to seek treatment for the same and thus are more prone to acquire other sexually transmitted infections. 4 The qualities of tinidazole and ornidazole with respect to their longer half-lives and their side effect profile as compared to oral metronidazole may result in being more efficacious for the treatment of BV.…”

“…This is unlike the high cure rates observed in a study by Thulkar et al with cure rates of 100% and 97.7% at one week and four weeks respectively. 11 In a study by Erkkola et al, single oral dose of ornidazole 1.5 g in 24 women with BV, conducted in Finland, showed subjective improvement in 96% of the patients. 31 These studies which used ornidazole are comparable to present study as the dose of ornidazole and follow up period was similar.…”