Once-Weekly Secnidazole Granules for the Treatment of Recurrent Bacterial Vaginosis [ID 775]

INTRODUCTION: Bacterial vaginosis (BV) is the most prevalent cause of vaginal symptoms in women nationally, with a greater than 50% recurrence rate. Patient compliance with complicated treatment regimens is a barrier to successful outcomes. Simplifying suppressive protocols could improve patient compliance and disease recurrence. Once-weekly secnidazole granules have a longer half-life and may provide an improved therapeutic window. The objective of this study was to evaluate the effectiveness of suppressive therapy with once-weekly secnidazole granules in the treatment of recurrent BV (RBV). METHODS: This was a prospective, longitudinal pilot study. We included women aged 18–50 with symptomatic RBV. We excluded women who failed initial therapy, had other infections, were pregnant or breastfeeding, or had a contraindication to secnidazole use. Patients were treated for 16 weeks with once-weekly secnidazole and were followed monthly for 3 months after suppressive therapy. We compared response rates to rates quoted in the medical literature. RESULTS: Twenty-four patients enrolled. Four patients were ineligible. Five patients failed initial therapy and were not eligible for suppressive therapy. Fifteen participants proceeded to the suppressive phase and were prescribed secnidazole for 16 weeks. Diagnosis and response rate were determined by Amsel’s criteria (3 or higher) and Nugent score (7 or higher). The total (28-week) recurrence rate was 20% (3/15) compared to 51% (26/51), 35%, and 70% (7/10) reported in the CDC treatment guidelines for RBV. Yeast infection was the most common side effect. CONCLUSIONS/IMPLICATIONS: Once-weekly oral secnidazole is a safe, less complicated regimen for the treatment of RBV, with similar effectiveness to previously published studies.