Study: Boric acid with antibiotics for BV – does it work?

Researchers looked into a topical boric acid treatment to possibly remove the bacterial biofilm found in recurrent bacterial vaginosis (BV), specifically when with nitroimidazole, an antibiotic. The results were that over time, the failure rate of this treatment was about the same as treating BV just with antibiotics – 50 per cent.

The study into boric acid and BV

The researchers looked at a triple-phase regime to reduce symptomatic recurrence of BV in 58 high-risk patients. Patients with recurrent bacterial vaginosis were treated with seven days of nitroimidazole with 21 days of intravaginal boric acid (600mg per day). If the patient was in remission, they were treated with metronidazole gel vaginally twice weekly for 16 weeks.

There were 77 episodes of BV treated in the 58 women, and 60 of those episodes were available for follow-up evaluation four and 12 weeks after enrolment in the study, after completion of the nitroimidazole and boric acid therapy, but before the vaginal metronidazole gel.

Results of the study

• Cure rates after nitroimidazole and boric acid therapy were 88 per cent at 7 weeks after the initial visit
• Cure rates after nitroimidazole and boric acid therapy were 92 per cent at 12 weeks after the initial visit
• Cumulative cure rates at 12 weeks after the initial visit were 87 per cent
• Cumulative cure rates at 16 weeks after the initial visit were 78 per cent
• Cumulative cure rates at 28 weeks after the initial visit were 65 per cent
• Failure rate of 50 per cent was documented at 36 weeks follow-up
• No adverse effects of boric acid were observed
• A researcher noted a personal observation that boric acid used on its own is not effective and it was not effective in this study

It was noted by the researchers that the study limitations included that it was an uncontrolled pilot in a single centre, treated was unblinded, lacked a control group or placebo, and lacked rigid time evaluation, and follow-up losses to the study were considerable.

References

Boric Acid Addition to Suppressive Antimicrobial Therapy for Recurrent Bacterial Vaginosis, Reichman, Orna MD*; Akins, Robert PHD†; Sobel, Jack D. MD, Sexually Transmitted Diseases: November 2009 – Volume 36 – Issue 11 – pp 732-734 doi: 10.1097/OLQ.0b013e3181b08456