Adjunct vaginal lactic acid with single-dose metronidazole for bacterial vaginosis: a randomized controlled trial

This randomized controlled trial aimed to determine whether adding a 7-day course of vaginal lactic acid to a single-dose oral metronidazole improves early ecological restoration and clinical outcomes in women with bacterial vaginosis. While the addition of lactic acid did not significantly enhance long-term Lactobacillus recovery or reduce recurrence rates, it resulted in a higher one-week clinical cure rate and faster relief from malodorous discharge. The study suggests that adjunctive vaginal lactic acid may offer a short-term symptomatic treatment option, particularly in resource-limited settings.