Trial reportPloS one2019
Acceptability of and treatment preferences for recurrent bacterial vaginosis-Topical lactic acid gel or oral metronidazole antibiotic: Qualitative findings from the VITA trial.
Trial report in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- The value of qualitative research in randomized controlled trials involving drugs and medical devices: a systematic mapping review.International journal of technology assessment in health care · 2026Pooled it
- Lactic acid-containing products for bacterial vaginosis and their impact on the vaginal microbiota: A systematic review.PloS one · 2021Pooled it
- Assessing the Efficacy of Ligilactobacillus salivarius CLS0420 and Lacticaseibacillus paracasei CLPC0603 on Vaginal Well-Being in Healthy Women: A Pilot, Randomized, Double-Blind, Placebo-Controlled Trial.Probiotics and antimicrobial proteins · 2026Trial
- Bacterial Vaginosis [BV] knowledge, attitudes and behavioural changes after BV diagnosis among women enrolled in a clinical trial in Boston, USA and Vulindlela, South Africa: a qualitative study.BMC women's health · 2025Trial
- Intravaginal lactic acid gel versus oral metronidazole for treating women with recurrent bacterial vaginosis: the VITA randomised controlled trial.BMC women's health · 2023Trial
- The Impact of the Vaginal Microbiome and Microbial Metabolites on HIV Transmission at the Female Reproductive Tract Epithelial Barrier.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026Review
- A prodrug strategy for sustained release of lactic acid from silicone elastomer vaginal rings.International journal of pharmaceutics · 2025Article
- Examining Women's Self-Management Strategies for Recurrent Bacterial Vaginosis in New York City.Sexually transmitted diseases · 2025Article
- Bacterial vaginosis.Nature reviews. Disease primers · 2025Review
- "If that would have lessened my symptoms, that would have been great...": a qualitative study about the acceptability of tecovirimat as treatment for mpox.BMC medicine · 2025Article
- Bridging the GAP: Probiotic Douches Redefining the Feminine Hygiene.Current pharmaceutical biotechnology · 2025Review
- Sustained dual delivery of metronidazole and viable Lactobacillus crispatus from 3D-printed silicone shells.Biomaterials advances · 2024Article
- Understanding Perceptions and Experiences on Acceptability of Oral Ivermectin, Topical Permethrin, and their Combination in the Treatment of Adult Filipino Patients with Scabies: A Multiple Case Study.Acta medica Philippina · 2024Article
- Efficacy of a Novel RigenaseMedicina (Kaunas, Lithuania) · 2023Observational
- Formulation and characterization of pressure-assisted microsyringe 3D-printed scaffolds for controlled intravaginal antibiotic release.International journal of pharmaceutics · 2023Article
- Scoping review of the association between bacterial vaginosis and emotional, sexual and social health.BMC women's health · 2023Article
- Barriers and facilitators of adherence to treatment among women with vulvovaginal candidiasis: a qualitative study.European journal of medical research · 2022Article
- Lactic acid from vaginal microbiota enhances cervicovaginal epithelial barrier integrity by promoting tight junction protein expression.Microbiome · 2022Article
- The Impact of Over-The-Counter Lactic Acid Containing Vaginal Gels on the Integrity and Inflammatory State of the Vaginal EpitheliumFrontiers in reproductive health · 2022Article
- Acidic Electrolyzed Water Inhibits the Viability ofFrontiers in medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundBacterial vaginosis (BV) is associated with an elevated vaginal pH and the presence of abnormal offensive discharge. It is common, often recurrent, and the most effective treatment regimen is unknown. 'Metronidazole Versus lactic acId for Treating bacterial vAginosis' (VITA) is a UK-based randomised controlled trial assessing clinical and cost-effectiveness of topical lactic acid gel compared to oral metronidazole antibiotic for treating second and subsequent BV episodes. Few BV trials report on women's preferences for treatment in the context of their own experiences.
methodThis qualitative study investigated the acceptability and tolerability of the two treatments. During the trial, semi-structured telephone interviews were undertaken between January-May 2018. A total of 33 women diagnosed with BV were consecutively sampled then interviewed from six sites across England. Thematic analysis was guided by the acceptability of health interventions framework. Potential causes of BV and its impact on women's lives were explored in addition to women's treatment preference and perceived treatment effectiveness.
resultsAlthough women felt antibiotics treat BV effectively, and were associated with longer time periods between episodes, they generally preferred using the lactic acid gel because of ease of use, once daily application and less side-effects. Women would recommend the lactic acid gel to others for mild cases of BV but to take antibiotics when more severe. The risk of antibiotic drug resistance was a common concern. Self-help medicating or self-decision to not treat was also evident due to prior experience of poor outcomes from treatment. Triggers of BV were attributed to personal hygiene habits-soaps used to wash the vagina and sexual practices such as unprotected sex.
conclusionAcceptability and preference for topical lactic acid gel or oral metronidazole tablets in the treatment of recurrent BV was affected by personal choice relating to affective attitude, burden, ethicality, intervention coherence, opportunity costs, and self-efficacy. These differed depending on ease of use, tolerability and past experiences, but not necessarily based on perceived drug effectiveness. Knowledge of a patient preference for topical lactic acid gel therapy despite lower perceived effectiveness may be useful for clinicians when making treatment decisions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.