A placebo-controlled, double-blind comparison of tinidazole and triple sulfonamide cream for the treatment of nonspecific vaginitis.

Oral tinidazole, 500 mg twice daily for 5 days, was compared to triple sulfonamide cream inserted into the vagina twice daily for 7 days for the treatment of nonspecific vaginitis in a placebo-controlled, double-blind trial. At 1 and 3 weeks after treatment, 29 of 30 and 18 of 19 patients, respectively, who had been given tinidazole were cured, as compared to 16 of 27 and 6 of 14 patients, respectively, who had been given oral placebo together with a vaginal cream with or without sulfonamides (p less than 0.01 and p = 0.0015, respectively). At 3 weeks, five of nine women who had received vaginal sulfonamide cream and oral placebo had persistent nonspecific vaginitis, thus suggesting that it was not more effective than a vaginal placebo cream. Untreated nonspecific vaginitis and persistence of this syndrome were significantly associated with Gardnerella vaginalis, anaerobic gram-negative rods, clue cells, a vaginal pH of greater than or equal to 5.0, a succinate/lactate peak heights ratio of greater than or equal to 0.3, and the absence of lactobacilli on a vaginal smear.