1Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
2Medicinal Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
Objective: Due to the high incidence of bacterial vaginosis (BV) and its resistance to chemical medications and considering the anti-bacterial and anti-fungal effects of Myrtus communis, the present study aimed to compare the therapeutic effects of the vaginal gel of M. communis 2% (in metronidazole base) with metronidazole vaginal gel 0.75% alone on BV.
Materials and Methods: This research was a randomized controlled clinical trial conducted on 80 women of 18-40 years old with BV. Patients were divided into two groups of 40 women. Diagnostic criteria were Amsel's criteria and Gram staining. The first group received vaginal gel of metronidazole plus M. communis 2% and the second group received metronidazole vaginal gel alone for five consecutive nights. Therapeutic effects and Amsel’s criteria were assessed after one week. Finally, the data were analyzed by SPSS 16 using t-test and Chi square tests.
Results: There was a significant difference in the therapeutic response between the two groups. The results demonstrated that the combination of metronidazole and M. communis had a higher efficiency (p<0.05). The patients receiving M. communis in metronidazole gel base did not experience any recurrent BV, but 30% of patients taking metronidazole alone faced recurrent BV after three weeks of follow up. Conclusion: Findings of the study suggested that adding M. communis extract to metronidazole increases the efficiency of BV treatment.
Al-Saimary IE, Bakr SS, Jaffar T, Al-Saimary AE, Salim H, Al-Muosawi R. 2002. Effects of some plant extracts and antibiotics on Pseudomonas aeruginosa isolated from various burn cases. Saudi Med J,7: 802-805.
Alipour G, Dashti S, Hosseinzadeh H. 2014. Review of pharmacological effects of Myrtus communis L. and its active constituents. Phytother Res, 8: 1125-1136.
Allsworth JE. 2010. Bacterial vaginosis-race and sexual transmission: issues of causation. Sex Transm Dis,3: 137-139.
Amirmohammadi M, Khajoenia S, Bahmani M, Rafieian-Kopaei M, Eftekhari Z, Qorbani M. 2014. In vivo evaluation of antiparasitic effects of Artemisia abrotanum and Salvia officinalis extracts on Syphacia obvelata, Aspiculoris tetrapetra and Hymenolepis nana parasites. Asian Pac J Trop Dis, 4: S250-S254.
Bahmani M, Rafieian-Kopaei M. 2014. Medicinal plants and secondary metabolites for leech control. Asian Pac J Trop Dis , 4: 315-316.
Brandt M, Abels C, May T, Lohmann K, Schmidts-Winkler I, Hoyme U. 2008. 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, 2: 158-162.
Danforth DN, Gibbs S. 2008. Danforth's obstetrics and gynecology, pp.112. Lippincott Williams & Wilkins.
Donders GG, Zodzika J, Rezeberga D. 2014. Treatment of bacterial vaginosis: what we have and what we miss. Expert Opin Pharmacother ,5: 645-657.
Farage MA, Miller KW, Ledger WJ. 2008. Determining the cause of vulvovaginal symptoms. Obstet Gynecol Surv,63: 445-464.
Ghasemi Dehkordi N, Sajadi S, Ghanadi A, Amanzadeh Y, Azadbakht M, Asghari GR, et al. 2003. Iranian herbal pharmacopoeia (IHP). Hakim Res J, 63-69.
Hosseinzadeh H, Khoshdel M, Ghorbani M. 2011. Antinociceptive, anti-inflammatory effects and acute toxicity of aqueous and ethanolic extracts of Myrtus communis L. aerial parts in mice. J Acupunct Meridian Stud, 4: 242-247.
Houshmand B, Mortazavi H, Alikhani Y, Abdolsamadi H, AhmadiMotemayel F, ZareMahmoudabadi R. 2011. In Vitro Evaluation of Antibacterial Effect of Myrtus Extract with Different Concentrations on Some Oral Bacteria. J Mashad Dent Sch, 35: 123-130.
Klebanoff MA, Nansel TR, Brotman RM, Zhang J, Yu K-F, Schwebke JR, et al.2010. Personal hygienic behaviors and bacterial vaginosis. Sex Transm Dis, 2: 94.
Koumans EH, Sternberg M, Bruce C, McQuillan G, Kendrick J, Sutton M, et al. 2007. The prevalence of bacterial vaginosis in the United States, 2001–2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis , 34: 864-869.
de Figueiredo Leite SR, de Amorim MM, Calábria WB, de Figueiredo Leite TN, de Oliveira VS, Ferreira Júnior JA, et al.2010. Clinical and microbiological profile of women with bacterial vaginosis. Revista Brasileira de Ginecologia e Obstetrícia ,2: 82-87.
Löfmark S, Edlund C, Nord CE. 2010. Metronidazole is still the drug of choice for treatment of anaerobic infections. Clin Infect Dis, 1: S16-S23.
Masoudi M, Miraj S, Rafieian-Kopaei M. 2016 .Comparison of the Effects of Myrtus Communis L, Berberis Vulgaris and Metronidazole Vaginal Gel alone for the Treatment of Bacterial Vaginosis. J clin diag res, 3.
Ness RB, Hillier SL, Kip KE, Soper DE, Stamm CA, McGregor JA, et al. 2004. "Bacterial vaginosis and risk of pelvic inflammatory disease. Obstet Gynecol ,4: 761-769.
Novak E , Berek S . 2007. Berek & Novak's gynecology, Lippincott Williams & Wilkins.
Rabiei Z, Rafieian-Kopaei M, Heidarian E, Saghaei E, Mokhtari S. 2014. Effects of Zizyphus jujube extract on memory and learning impairment induced by bilateral electric lesions of the nucleus Basalis of Meynert in rat. Neurochem res , 2: 353-360.
Rafiean-Kopaei M, Baradaran A, Maghsoudi AR, Ghobadi Sh, Nasri H. Nasri. 2012. Helicobacter pylori infection and serum homocysteine in hemodialysis patient. Life Sci J ,4.
Reichman O, Akins R, Sobel JD. 2009. Boric acid addition to suppressive antimicrobial therapy for recurrent bacterial vaginosis. Sex Transm Dis, 11: 732-734.
Riggs M, Klebanoff M, Nansel T, Zhang J, Schwebke J, Andrews W. 2007. Longitudinal association between hormonal contraceptives and bacterial vaginosis in women of reproductive age. Sex Transm Dis, 12: 954-959.
Rossi A, Di Paola R, Mazzon E, Genovese T, Caminiti R, Bramanti P, et al. 2009. Myrtucommulone from Myrtus communis exhibits potent anti-inflammatory effectiveness in vivo. J Pharmacol ExpTher, 1: 76-86.
Schwebke JR, Desmond RA, Oh MK. 2004. Predictors of bacterial vaginosis in adolescent women who douche. Sex Transm Dis ,7: 433-436.
Sharafati-chaleshtori R, Mahmoud Rafieian-kopaei M. 2014. Screening of antibacterial effect of the Scrophularia Striata against E. coli in vitro. J HerbMed Pharmacol , 3:31-34.
Shirzad H, Taji F, Rafieian-Kopaei M. 2011. Correlation between antioxidant activity of garlic extracts and WEHI-164 fibrosarcoma tumor growth in BALB/c mice. J Med Food, 9: 969-974.
Simbar M, Azarbad Z, Mojab F, Alavi Majd H. 2008. A comparative study of the therapeutic effects of the Zataria multiflora vaginal cream and metronidazole vaginal gel on bacterial vaginosis. Phytomedicine , 12: 1025-1031.
Sobel JD. 2000. Bacterial vaginosis. Annu Rev Med, 1: 349-356.
Sobel JD, Ferris D, Schwebke J, Nyirjesy P, Wiesenfeld HC, Peipert J, et al. 2006. Suppressive antibacterial therapy with 0.75% metronidazole vaginal gel to prevent recurrent bacterial vaginosis. Am J Obstet Gynecol , 5: 1283-1289.
Seyyedi F, Rafiean-Kopaei M, Miraj S. 2016. Comparison of the Effects of Vaginal Royal Jelly and Vaginal Estrogen on Quality of Life, Sexual and Urinary Function in Postmenopausal Women. J Clin Diag Res, 10.
Verstraelen H, Verhelst R. 2009. Bacterial vaginosis: an update on diagnosis and treatment. Expert Rev Anti Infect Ther, 9: 1109-1124.