Efficacy and safety of single dose of oral secnidazole 2 g in treatment of bacterial vaginosis: A systematic review and meta-analysis

Background: Bacterial vaginosis (BV) is a common disease characterized by vaginal discharge.

Objective: To evaluate the evidence from published randomized clinical trials (RCTs) about the efficacy and safety of single dose of oral secnidazole 2 g in comparison with other drugs.

Search strategy: Electronic databases were searched using the following MeSH terms (bacterial vaginosis OR vaginosis) AND (secnidazole OR secnol OR sabima OR secnidal OR minovage).

Selection criteria: All RCTs assessing effect of secnidazole in treatment of BV were considered for this meta-analysis. Two-hundred thirty two studies were identified of which six studies were deemed eligible for this review.

Data collection and analysis: The extracted data were entered into RevMan software. The relative risk (RR) and 95% confidence interval (CI) were calculated. The extracted outcomes were the clinical cure and adverse effects.

Main results: The pooled estimate showed that ornidazole is superior to a single dose of oral secnidazole in clinical cure at the 4th week after treatment (RR = 0.81; 95% CI [0.73- 0.89], p < 0.0001, I² = 0%). There were no difference between secnidazole and metronidazole (RR = 0.97; 95% CI [0.90-1.05], I² = 0%, p = 0.5).

Conclusions: Single oral dose of secnidazole 2 g doesn't differ from metronidazole regimen however, it may be inferior to ornidazole in treatment of BV.