Comparing the Therapeutic Effects of Garlic Tablet and Oral Metronidazole on Bacterial Vaginosis: A Randomized Controlled Clinical Trial

Abstract

Background:Bacterial vaginosis (BV) is one of the most common gynecological infections during reproductive age. Although metronidazole is one of the most effective medications recommended as the first-line treatment, it has various side effects. Because of the side effects and contraindications of some chemical medicines, using herbs has been investigated in treating BV.Objectives:The aim of this study was to compare the effect of garlic tablet (Garsin) and oral metronidazole in clinical treatment of the BV in women referred to Resalat Health Center, affiliated with Mazandaran University of Medical Sciences, in 2013.Patients and Methods:This randomized clinical trial was conducted on 120 married women aged 18 to 44 years who were diagnosed with BV by Amsel’s clinical criteria and Gram staining. Enrolled women were randomly allocated to two groups of 60 patients and were treated with either garlic tablet or oral metronidazole for seven days. Amsel’s criteria and Gram stain were assessed seven to ten days after beginning the treatment period and side effects were registered.Results:Amsel’s criteria were significantly decreased after treatment with garlic or metronidazole (70% and 48.3%, respectively; P < 0.001). Therapeutic effects of garlic on BV were similar to that of metronidazole (63.3% and 48.3%, respectively; P = 0.141). There were significant differences between the two treatment groups in terms of side effects; metronidazole was associated with more complications (P = 0.032).Conclusions:This study reveals that garlic could be a suitable alternative for metronidazole in treatment of BV in those interested in herbal medicines or those affected by side effects of metronidazole.

Bacterial Vaginosis Biofilms: Challenges to Current Therapies and Emerging Solutions

“…One of the earliest reports on this topic dates back from 1991, when Blackwell described the first therapeutic success of using plants extracts to treat BV (Blackwell, 1991 ). Subsequently, several clinical trials have demonstrated that the use of plant-derived compounds promoted the reduction of BV symptoms and are associated with high cure rates and tolerability, including a polyherbal vaginal pessary (Patel et al, 2008 ), vaginal cream containing Zataria multiflora (Abdali et al, 2015 ), a vaginal douche of thymol and eugenol (main constituents of thyme oil and clove oil; Sosto et al, 2011 ), watery extract of Triticum vulgare (Boselli et al, 2012 ) and garlic tablets (Mohammadzadeh et al, 2014 ). Surprisingly, up to now only one study evaluated the capability of plant-derived compound to eradicate BV biofilms.…”

Bacterial vaginosis: a review of approaches to treatment and prevention

“…Garlic's antibacterial properties have been sparsely studied in the context of BV. One single-blinded study ( n = 120) found that oral garlic tablets and oral metronidazole have similar effectiveness in treating BV ( 114 ); however, the study was underpowered and did not adhere to CONSORT guidelines for reporting. No other studies have examined garlic intake in the context of BV.…”

Bacterial Vaginosis: A Clinical Update with a Focus on Complementary and Alternative Therapies

“…Evaluation at 7 to 10 days after beginning treatment found that treatment with garlic was as effective as treatment with metronidazole (63.3% and 48.3%, respectively; P = .141). The garlic group experienced more nausea and heartburn, but the metronidazole group experienced more vomiting, diarrhea, and headache …”