A Randomized Controlled Trial of Metronidazole Vaginal Cream in the Treatment of Papanicolaou Smears Showing Atypical Squamous Cells of Undetermined Significance (ASCUS).

Author(s): Thompson LC, O'connor P, Gibbs RS

Affiliation(s): Department of Obstetrics and Gynecology, University of Colorado, Health Sciences Center, Denver, Colorado.

Publication date & source: 2001-10, J Low Genit Tract Dis., 5(4):219-222.

Publication type:

OBJECTIVE: To compare topical metronidazole gel vs. placebo to assess resolution to normal in subsequent Pap smears of patients with ASCUS. MATERIALS AND METHODS: Patients with ASCUS pap smears were randomized to metronidazole or placebo. Resolution of ASCUS vs. persistence, or progression, was the endpoint. A subanalysis stratified patients for bacterial vaginosis (BV) to determine if this population responded differently. Discrete variables were compared using chi-square analysis. RESULTS: Forty-nine patients received metronidazole and 52 received placebo. The rate of resolution in the placebo group were 60%, and 67% in the metronidazole group. With BV, the rate of resolution in the placebo group was 67%, and 70% in the metronidazole group. These were not significantly different. CONCLUSIONS: Treatment of ASCUS Pap smears using topical metronidazole did not demonstrate a significant increase in the rate of resolution in subsequent Pap smears in the overall group nor in a subgroup with BV.