Chlorhexidine in the treatment of vaginal infections
In developed countries, bacterial vaginosis and vaginal candidiasis are the most common vaginal infections in women. Standard treatment options are metronidazole or clindamycin and topical imidazoles, respectively. However, a combined lesion of the fungal and bacterial flora is often observed. Chlorhexidine is an antiseptic with a broad spectrum of activity, both against bacteria and fungi. Recently, a new bio-adhesive vaginal gel based on chlorhexidine, Clomirex (Mipharm), has been developed.
A multicenter, randomized comparative study of the efficacy and tolerability of chlorhexidine in acute vaginal infection involved 90 women (45 diagnosed with bacterial vaginosis and 45 with vaginal candidiasis). 60 patients received 0.5% vaginal chlorhexidine gel (2.5 g / day), 15 - metronidazole as vaginal tablets 500 mg / day, and 15 - 2% clotrimazole cream once daily for 1 week, depending on the etiology of the process followed by observation for 3 weeks.
With bacterial vaginosis, clinical cure was observed in 93% of patients receiving chlorhexidine gel, compared to 74% in the group of patients receiving metronidazole; in both cases, there was a significant decrease in vaginal pH at week 4 of the study. In vaginal candidiasis, clinical healing was observed in 87% of patients receiving chlorhexidine gel, compared to 86% in the group of women receiving clotrimazole.
10% of patients treated with chlorhexidine gel therapy had a mild burn at the site of drug application; no serious adverse event was detected. Tolerance to the gel was rated "good" or "very good" by most (90%) of the patients.
Thus, with bacterial vaginosis and vaginal candidiasis, a short course of chlorhexidine gel therapy is equivalent in effectiveness to standard methods. More research is needed to assess the safety and tolerability of longer treatments.