Work

Tinidazole vs metronidazole for the treatment of bacterial vaginosis: a systematic review and meta-analysis

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Tinidazole shows potential as a first-line treatment for bacterial vaginosis (BV). However, its superiority to metronidazole remains uncertain. Therefore, this meta-analysis compares tinidazole versus metronidazole in patients with BV. We systematically searched PubMed, Embase and Cochrane for studies comparing tinidazole and metronidazole in patients with BV. Statistical analyses were performed using R Studio 4.3.2. Heterogeneity was examined with the Cochran Q test and I 2 statistics. Risk ratios (RR) with 95% confidence intervals (CI) were pooled across trials. Outcomes of interest were BV cure at the first and the second follow-up appointment, and adverse events such as nausea and bad or metallic taste. Five randomized controlled trials and 1 prospective observational study, reporting data on 1,036 patients were included in this meta-analysis. Among them, 511 (49%) received tinidazole and 525 (51%) received metronidazole. Follow-up ranged from 1 to 6 weeks. There was no significant difference between groups for BV cure at the first follow-up appointment (RR 1.03; 95% CI 0.92 to 1.14; I 2 = 76%), cure at the second follow-up appointment (RR 1.05; 95% CI 0.80–1.38; I 2 = 88%), nausea (RR 0.89; 95% CI 0.39–2.04; I 2 = 83%), and bad or metallic taste (RR 0.74; 95% CI 0.12–4.45; I 2 = 89%). In patients with BV, tinidazole and metronidazole exhibit similar efficacy and safety, with equivalent cure rates and incidence of adverse events.

Source: Archives of Gynecology and Obstetrics

DOI: 10.1007/s00404-024-07899-z