Controlled study on thymol + eugenol vaginal douche versus econazole in vaginal candidiasis and metronidazole in bacterial vaginosis

PURPOSE OF THE STUDY: Bacterial vaginosis (BV) and vaginal candidiasis (VC) are usually managed with topical antibiotics. This study compared the efficacy of a thymol + eugenol vaginal douche (SD) (CAS nr. thymol: 89-83-8 and eugenol: 97-53-0), with econazole (CAS 27220-47-9) in VC and metronidazole (CAS 443-48-1) in BV, as suppository reference therapies. Thymol and eugenol are natural antibacterial and antimycotic active ingredients extracted from plants. METHODS: A multicentre, parallel group, randomized study was performed, after stratification for diagnosis. Twenty-three Italian gynaecological units enrolled 459 patients (232 BV, 227 VC). The treatments applied were as follows: SD 1 douche/day (Saugella lavanda Attiva) for 1 week, 1 metronidazole vaginal suppository/night for 1 week and 1 econazole vaginal suppository/night for 3 days. Clinical evaluations were performed before and 1 week after treatment. RESULTS: A similar significant symptom reduction was observed with metronidazole and SD in BV and with econazole and SD in VC. CONCLUSION: SD was found to be an effective prescription drug in minor recurrent vaginal infectious episodes and its use can reduce the repeated exposure to antibiotics.