Randomized clinical trial comparing the efficacy of the vaginal use of metronidazole with a Brazilian pepper tree (Schinus) extract for the treatment of bacterial vaginosis

• Published in: Brazilian journal of medical and biological research Vol. 44; no. 3; pp. 245 - 252
• Main Authors: Leite, S R R F, Amorim, M M R, Sereno, P F B, Leite, T N F, Ferreira, J A C, Ximenes, R A A
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Associação Brasileira de Divulgação Científica 01.03.2011
• Subjects: Administration, Intravaginal; Adult; Anacardiaceae - chemistry; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Bacteria; Bacterial vaginosis; BIOLOGY; Brazilian pepper tree; Double-Blind Method; Female; Gardnerella vaginalis; Humans; MEDICINE, RESEARCH & EXPERIMENTAL; Metronidazole - administration & dosage; Metronidazole - therapeutic use; Metronidazole vaginal gel; Phytotherapy - methods; Plant Extracts - administration & dosage; Plant Extracts - therapeutic use; Schinus; Schinus terebinthifolius; Treatment Outcome; Vaginal Creams, Foams, and Jellies; Vaginosis, Bacterial - drug therapy; Young Adult; Metronidazole vaginal gel; Bacterial vaginosis; Gardnerella vaginalis; Brazilian pepper tree
• ISSN: 0100-879X; 1414-431X; 1414-431X; 0100-879X
• DOI: 10.1590/S0100-879X2011007500003

A 7.4% vaginal extract of the Brazilian pepper tree (Schinus terebinthifolius Raddi) was compared with 0.75% vaginal metronidazole, both manufactured by the Hebron Laboratory, for the treatment of bacterial vaginosis, used at bedtime for 7 nights. The condition was diagnosed using the combined criteria of Amsel and Nugent in two groups of 140 and 137 women, aged between 18 and 40 years. Intention-to-treat analysis was performed. Women were excluded from the study if they presented delayed menstruation, were pregnant, were using or had used any topical or systemic medication, presented any other vaginal infections, presented hymen integrity, or if they reported any history suggestive of acute pelvic inflammatory disease. According to Amsel's criteria separately, 29 patients (21.2%) treated with the extract and 87 (62.1%) treated with metronidazole were considered to be cured (P < 0.001). According to Nugent's score separately, 19 women (13.9%) treated with the extract and 79 (56.4%) treated with metronidazole were considered to be cured (P < 0.001). Using the two criteria together, the so-called total cure was observed in 17 women (12.4%) treated with the extract and in 79 women (56.4%) treated with metronidazole (P < 0.001). In conclusion, the cure rate for bacterial vaginosis using a vaginal gel from a pepper tree extract was lower than the rate obtained with metronidazole gel, while side effects were infrequent and non-severe in both groups.