Tratamiento de la vaginosis bacteriana: comparación clindamicina (pauta corta, vaginal)- tinidazol (dosis única, oral). Estudio prospectivo de 2 años

Abstract

Objetivo: Estudio comparativo para el tratamiento de Vaginosis Bacteriana con clindamicina y tinidazol, viendo el resultado del cultivo microbiológico después de 1 y 3 meses. Diseño: El grupo clindamicina consta de 201 casos, tratados a lo largo de 1 año con un óvulo vaginal / noche (3 días). El grupo tinidazol consta de 204 casos, tratados a lo largo de 1 año con 4 comprimidos / día por vía oral, (1 día). Se tomaron muestras vaginales para cultivo microbiológico a 1 y 3 meses. Resultados: Hubo diferencias significativas, p< 0,001, en edad y paridad, siendo mayores en Tinidazol (T). No hubo diferencias en nuligestas, pero sí en menopáusicas que fueron 18,13% en T. No hubo diferencias en antecedentes de infecciones vaginales ni lesiones cervicales, ni en uso de métodos contraceptivos. Hubo diferencias en no relaciones sexuales, p< 0,001, mayores en clindamicina (C), en 22,38%. No hubo diferencias en sexo oral ni en sexo anal, pero sí en parejas múltiples simultáneas (PMS), p< 0,05, mayores en C, 5,47%. Hubo diferencias en el cultivo al mes 1, p< 0,001, siendo negativo en C en 52,04% frente a 32,16% en T. Gardnerella vaginalis persiste en 68,10 % en T (p< 0,001). Hubo diferencias, igualmente, en el cultivo al mes 3, p< 0,001, siendo negativos en 56,34 % en C frente a 30,88% en T. Gardnerella vaginalis persiste en 59,57% en T. Conclusiones: Con clindamicina se obtienen mejores resultados en los cultivos, siendo negativos a 1 mes en 52,04%, y a 3 meses en 56,34%, pero no son satisfactorios, ya que Gardnerella vaginalis persiste en 26,59% y 45,45%, respectivamente.

Objective: Comparative study for the treatment of Bacterial Vaginosis with clindamycin versus tinidazole, whereas the results of microbiologic cultures at 1 and 3 months. Design: The clindamycin group (C) were 201 cases, treated along one year with 1 vaginal ovule / night, 3 days. The tinidazole group (T) were 204 cases, treated along one year with 4 oral tablets of 500 mg, one day (2 tablets / 12 hours). We performed microbiologic cultures at 1 and 3 months. Results: There were statistically significant differences, p< 0,001, in age and parity , which were bigger in T group. No differences in nulligravides, but there were in menopausals, that were the 18,13% in T group. No differences in vaginal infections or cervical lesions antecedent, nor in use of contraceptive methods. There were differences in no intercourse, p< 0,001, bigger in C group, 22,38%. No differences in oral sex nor anal sex, but there were in simultaneous multiple partners (SMP), p< 0,05, bigger in C group , 5,47%. There were differences in the culture at 1 month, p< 0,001, which were negative in C group in 52,04% versus 32,16% in T group. Gardnerella vaginalis persisted in 68,10% in T group (p< 0,001). There were also differences in the culture at 3 months, p< 0,001, which were negative in 56,34% in C group versus 30,88% in T group. Gardnerella vaginalis persisted in 59,57% in T group. Conclusions: With clidamycin there were better results in the cultures , at 1 month that were negatives in 52,04%, and at 3 months in 56,34% , but they are not satisfactories, since Gardnerella vaginalis persisted in 26,59% and 45,45% , respectively.