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REVIEW article

Front. Cell. Infect. Microbiol.
Sec. Clinical Microbiology
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1402346

Efficacy and Safety of Different Drugs for the Treatment of Bacterial Vaginosis: A Systematic Review and Network Meta-analysis

Provisionally accepted
Yuxin Fan Yuxin Fan *Yanhong Gu Yanhong Gu Yi Xian Yi Xian Qinya Li Qinya Li Youli He Youli He Kaiyang Chen Kaiyang Chen Hui Yu Hui Yu Huan Deng Huan Deng Li Xiong Li Xiong Zhiwei Cui Zhiwei Cui Yang Yang Yang Yang Yin Xiang Yin Xiang
  • The People's Hospital of Leshan, Leshan, China

The final, formatted version of the article will be published soon.

    OBJECTIVE Bacterial vaginosis is a disease caused by vaginal microecology disorder, which seriously affects female health. At present, there are many drugs to treat BV, and this study aims to compare the efficacy and safety of multiple drugs for BV through a network meta-analysis (NMA).METHODS All studies were sourced from PubMed and Embase databases from the establishment date to April 13, 2023. We evaluated the clinical cure success rate and adverse effects (abnormal increase in vaginal discharge, external genital irritation, and vulvar itching) and performed subgroup analyses of the clinical cure success rate for different modes of administration.All statistical analyses were performed using R and STATA 14.0 software for network metaanalysis.We included 42 studies that met the criteria, involving a total of 8382 patients.Network meta-analysis results showed that metronidazole and secnidazole had a higher rate of adverse reactions than placebo (RR 7.06; 95%-CI 2.61-19.10, RR 4.03; 95%-CI 1.63-9.98), the adverse reaction rate of probiotics group was lower than that of metronidazole group (RR 0.44; 95%-CI 0.21-0.93). The clinical cure rate of oral ornidazole was better than clindamycin (RR 16.08; 95%-CI 1.72-150.47), Secnidazole (RR 8.17; 95%-CI 1.66-40.25) and probiotics. Direct meta-analysis results showed that ornidazole had a better clinical cure rate than Secnidazole (RR 批注 [奇刘1]: Change agents to drugs 批注 [奇刘2]: For the adverse events mentioned in the abstract, we made a supplementary explanation, including abnormal increase of vaginal discharge, external genital stimulation and genital pruritus.1.22; 95%-CI 1.10-1.34), oral ornidazole had a better clinical cure rate than Secnidazole (RR 1.23; 95%-CI 1.11-1.36). The clinical cure rate of vaginal application of sucrose was better than metronidazole (RR 1.12; 95%-CI 1.03-1.21) and metronidazole had a lower clinical cure rate than probiotics (RR 0.68; 95%-CI 0.52-0.88).The results of this systematic review and network meta-analysis suggest that ornidazole may be an effective alternative for the treatment of BV, and that sucrose and probiotics are potential BV treatments that need to be validated by more high-quality clinical studies in the future.

    Keywords: bacterial vaginosis, Treatment, antibiotic, Sucrose, Network meta-analysis

    Received: 17 Mar 2024; Accepted: 29 Aug 2024.

    Copyright: © 2024 Fan, Gu, Xian, Li, He, Chen, Yu, Deng, Xiong, Cui, Yang and Xiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yuxin Fan, The People's Hospital of Leshan, Leshan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.