Single hydrogen peroxide vaginal douching versus single-dose oral metronidazole for the treatment of bacterial vaginosis: a randomized controlled trial.

Objective: To compare the effectiveness of single hydrogen peroxide vaginal douching and a single oral dose of metronidazole for the treatment of bacterial vaginosis.

Method: A randomized trial was performed at the outpatient clinic in King Chulalongkorn Memorial Hospital. 142 patients diagnosed as having bacterial vaginosis were randomly allocated into two groups. The subjects in the first group were douched with 20 milliliters of 3 per cent hydrogen peroxide and received an oral placebo. The subjects in the second group received oral metronidazole 2 grams orally and were douched with a placebo. The cure rate in each group was assessed using Amsel's criteria 2 weeks after treatment.

Result: The cure rate in the subjects treated with hydrogen peroxide douching was lower than the cases who received oral metronidazole (62.5% versus 78.6%, p-value = 0.036). Rate of gastrointestinal side effects in metronidazole group was higher than in the hydrogen peroxide group (48.6% versus 13.9%, p-value < 0.001).

Conclusion: Single hydrogen peroxide vaginal douching was less effective than a single oral dose of metronidazole in the treatment of bacterial vaginosis.