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A randomized controlled trial conducted in Europe found that dequalinium chloride has good efficacy for treating bacterial vaginosis (BV) in women without the use of antibiotics. When compared with the antibiotic metronidazole, dequalinium chloride was not only noninferior, it also had better tolerability and fewer adverse events, as published in JAMA Network Open. Study authors believe dequalinium chloride could help reduce antibiotic consumption and could be considered as first-line treatment for bacterial vaginosis with less likelihood of resistance. The difference in the clinical cure rate between dequalinium chloride and metronidazole was −0.5, according to the journal. More patients who received dequalinium chloride rated the tolerability as very good compared with those who received metronidazole.

What it is: In use for at least 30 years, dequalinium chloride is a broad-spectrum antiseptic effective against gram-positive and gram-negative bacteria, fungi, and protozoa. The authors note that thanks to its multiple modes of action, the development of resistance to dequalinium chloride is unlikely.

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Non-Antibiotic Treatment for Bacterial Vaginosis Could Be a First-Line Choice