治愈率:有高质量证据表明,相对于单次服药,每日2次口服抗菌药甲硝唑7天,可有效提高治愈率。[33]Menard JP. Antibacterial treatment of bacterial vaginosis: current and emerging therapies. Int J Womens Health. 2011;3:295-305.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181210/?tool=pubmedhttp://www.ncbi.nlm.nih.gov/pubmed/21976983?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
治愈率:有高质量证据表明,相对于单次服药,每日2次口服抗菌药甲硝唑7天,可有效提高治愈率。[33]Menard JP. Antibacterial treatment of bacterial vaginosis: current and emerging therapies. Int J Womens Health. 2011;3:295-305.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181210/?tool=pubmedhttp://www.ncbi.nlm.nih.gov/pubmed/21976983?tool=bestpractice.com
临床治愈:有高质量证据表明,阴道用药和口服唑类药物治疗念珠菌病,在临床治愈率方面并没有差异。[39]Nurbhai M, Grimshaw J, Watson M, et al. Oral versus intra-vaginal imidazole and triazole anti-fungal treatment of uncomplicated vulvovaginal candidiasis (thrush). Cochrane Database Syst Rev. 2007;(4):CD002845.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002845.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/17943774?tool=bestpractice.com两种方式治疗均出现了不良反应。
系统评价或者受试者>200名的随机对照临床试验(RCT)。
临床治愈:有高质量证据表明,阴道用药和口服唑类药物治疗念珠菌病,在临床治愈率方面并没有差异。[39]Nurbhai M, Grimshaw J, Watson M, et al. Oral versus intra-vaginal imidazole and triazole anti-fungal treatment of uncomplicated vulvovaginal candidiasis (thrush). Cochrane Database Syst Rev. 2007;(4):CD002845.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002845.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/17943774?tool=bestpractice.com两种方式治疗均出现了不良反应。
临床治愈:有高质量证据表明,甲硝唑阴道用药相比口服用药,在治疗细菌性阴道病方面同样有效,而不良事件发生更少。[31]Brandt M, Abels C, May T, et al. Intravaginally applied metronidazole is as effective as orally applied in the treatment of bacterial vaginosis, but exhibits significantly less side effects. Eur J Obstet Gynecol Reprod Biol. 2008;141:158-162.http://www.ncbi.nlm.nih.gov/pubmed/18775597?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
临床治愈:有高质量证据表明,甲硝唑阴道用药相比口服用药,在治疗细菌性阴道病方面同样有效,而不良事件发生更少。[31]Brandt M, Abels C, May T, et al. Intravaginally applied metronidazole is as effective as orally applied in the treatment of bacterial vaginosis, but exhibits significantly less side effects. Eur J Obstet Gynecol Reprod Biol. 2008;141:158-162.http://www.ncbi.nlm.nih.gov/pubmed/18775597?tool=bestpractice.com
治愈率:有中等质量的循证显示,对患细菌性阴道病的女性,使用甲硝唑凝胶或克林霉素软膏阴道内抗菌治疗25-39天时,与安慰剂组相比在提高治愈率方面更加有效。[31]Brandt M, Abels C, May T, et al. Intravaginally applied metronidazole is as effective as orally applied in the treatment of bacterial vaginosis, but exhibits significantly less side effects. Eur J Obstet Gynecol Reprod Biol. 2008;141:158-162.http://www.ncbi.nlm.nih.gov/pubmed/18775597?tool=bestpractice.com[32]Oduyebo OO, Anorlu RI, Ogunsola FT, et al. The effects of antimicrobial therapy on bacterial vaginosis in non-pregnant women. Cochrane Database Syst Rev. 2009;(3):CD006055.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006055.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/19588379?tool=bestpractice.com口服甲硝唑会引起恶心和口腔金属味。
系统评价或者受试者>200名的随机对照临床试验(RCT)。
治愈率:有中等质量的循证显示,对患细菌性阴道病的女性,使用甲硝唑凝胶或克林霉素软膏阴道内抗菌治疗25-39天时,与安慰剂组相比在提高治愈率方面更加有效。[31]Brandt M, Abels C, May T, et al. Intravaginally applied metronidazole is as effective as orally applied in the treatment of bacterial vaginosis, but exhibits significantly less side effects. Eur J Obstet Gynecol Reprod Biol. 2008;141:158-162.http://www.ncbi.nlm.nih.gov/pubmed/18775597?tool=bestpractice.com[32]Oduyebo OO, Anorlu RI, Ogunsola FT, et al. The effects of antimicrobial therapy on bacterial vaginosis in non-pregnant women. Cochrane Database Syst Rev. 2009;(3):CD006055.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006055.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/19588379?tool=bestpractice.com口服甲硝唑会引起恶心和口腔金属味。
复发:有中等质量证据显示,细菌性阴道病的复发发生在抗菌治疗后。[34]Sobel JD, Ferris D, Schwebke J, et al. Suppressive antibacterial therapy with 0.75% metronidazole vaginal gel to prevent recurrent bacterial vaginosis. Am J Obstet Gynecol. 2006;194:1283-1289.http://www.ncbi.nlm.nih.gov/pubmed/16647911?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
复发:有中等质量证据显示,细菌性阴道病的复发发生在抗菌治疗后。[34]Sobel JD, Ferris D, Schwebke J, et al. Suppressive antibacterial therapy with 0.75% metronidazole vaginal gel to prevent recurrent bacterial vaginosis. Am J Obstet Gynecol. 2006;194:1283-1289.http://www.ncbi.nlm.nih.gov/pubmed/16647911?tool=bestpractice.com
预防:有中等质量证据表明,相对于未治疗男性伴侣,用口服抗菌药治疗固定男性伴侣,在降低治疗中的细菌性阴道病女性复发率方面并未更加有效。[12]Workowski KA, Bolan GA; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1-137.http://www.cdc.gov/std/tg2015/http://www.ncbi.nlm.nih.gov/pubmed/26042815?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
预防:有中等质量证据表明,相对于未治疗男性伴侣,用口服抗菌药治疗固定男性伴侣,在降低治疗中的细菌性阴道病女性复发率方面并未更加有效。[12]Workowski KA, Bolan GA; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1-137.http://www.cdc.gov/std/tg2015/http://www.ncbi.nlm.nih.gov/pubmed/26042815?tool=bestpractice.com
治愈率:有质量较差的证据显示,相对于甲硝唑治疗非妊娠细菌性阴道病妇女,7-10天疗程的克林霉素可以有效提高治愈率。[32]Oduyebo OO, Anorlu RI, Ogunsola FT, et al. The effects of antimicrobial therapy on bacterial vaginosis in non-pregnant women. Cochrane Database Syst Rev. 2009;(3):CD006055.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006055.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/19588379?tool=bestpractice.com阴道用克林霉素可引起轻至重度的大肠炎和阴道念珠菌病。
系统评价或者受试者>200名的随机对照临床试验(RCT)。
治愈率:有质量较差的证据显示,相对于甲硝唑治疗非妊娠细菌性阴道病妇女,7-10天疗程的克林霉素可以有效提高治愈率。[32]Oduyebo OO, Anorlu RI, Ogunsola FT, et al. The effects of antimicrobial therapy on bacterial vaginosis in non-pregnant women. Cochrane Database Syst Rev. 2009;(3):CD006055.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006055.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/19588379?tool=bestpractice.com阴道用克林霉素可引起轻至重度的大肠炎和阴道念珠菌病。
妊娠女性并发症:有质量较差证据表明,抗菌药物可以降低既往有过早产病史的孕妇分娩低出生体重婴儿风险,但并不知道在降低早产风险方面是否更加有效。[50]Svare JA, Schmidt H, Hansen BB, et al. Bacterial vaginosis in a cohort of Danish pregnant women: prevalence and relationship with preterm delivery, low birthweight and perinatal infections. BJOG. 2006;113:1419-1425.http://www.ncbi.nlm.nih.gov/pubmed/17010117?tool=bestpractice.com[51]McGregor JA, French JI, Parker R, et al. Prevention of premature birth by screening and treatment for common genital tract infections: results of a prospective controlled evaluation. Am J Obstet Gynecol. 1995;173:157-167.http://www.ncbi.nlm.nih.gov/pubmed/7631673?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
妊娠女性并发症:有质量较差证据表明,抗菌药物可以降低既往有过早产病史的孕妇分娩低出生体重婴儿风险,但并不知道在降低早产风险方面是否更加有效。[50]Svare JA, Schmidt H, Hansen BB, et al. Bacterial vaginosis in a cohort of Danish pregnant women: prevalence and relationship with preterm delivery, low birthweight and perinatal infections. BJOG. 2006;113:1419-1425.http://www.ncbi.nlm.nih.gov/pubmed/17010117?tool=bestpractice.com[51]McGregor JA, French JI, Parker R, et al. Prevention of premature birth by screening and treatment for common genital tract infections: results of a prospective controlled evaluation. Am J Obstet Gynecol. 1995;173:157-167.http://www.ncbi.nlm.nih.gov/pubmed/7631673?tool=bestpractice.com