Scolaris Content Display Scolaris Content Display

Tratamiento con antibióticos para las parejas sexuales de las pacientes con vaginosis bacteriana

Appendices

Appendix 1. MEDLINE and CENTRAL search strategy

1 exp Vaginosis, Bacterial/
2 (vagin$ adj5 bacteri$).tw.
3 1 or 2
4 exp Bacterial Infections/
5 (bacteri$ adj5 infection$).tw.
6 4 or 5
7 exp Vaginitis/
8 vaginiti*.tw.
9 vaginosis.tw.
10 colpitis.tw.
11 kolpitis.tw.
12 or/7‐11
13 6 and 12
14 3 or 13
15 (antibacterial adj5 therapy).tw.
16 (antimicrobial adj5 treatment).tw.
17 (antimicrobial adj5 therapy).tw.
18 (antibacterial adj5 treatment).tw.
19 15 or 16 or 17 or 18
20 exp Anti‐Infective Agents/
21 (anti‐infective adj5 agent$).tw.
22 (antiinfective adj5 agent$).tw.
23 microbicide$.tw.
24 (anti‐microbial adj5 agent$).tw.
25 (antimicrobial adj5 agent$).tw.
26 exp Anti‐Bacterial Agents/
27 antibiotic$.tw.
28 (anti‐bacterial adj5 agent$).tw.
29 (antibacterial adj5 agent$).tw.
30 bacteriocid$.tw.
31 or/20‐30
32 exp Therapeutics/
33 therap$.tw.
34 treatment$.tw.
35 or/32‐34
36 31 and 35
37 19 or 36
38 exp Sexual Partners/
39 (sexual adj5 partner$).tw.
40 (multiple adj5 partners).tw.
41 38 or 39 or 40
42 randomized controlled trial.pt.
43 controlled clinical trial.pt.
44 randomized.ab.
45 placebo.ab.
46 clinical trials as topic.sh.
47 randomly.ab.
48 trial.ti.
49 OR/42‐48
50 exp animals/ not humans.sh.
51 59 not 50
52 37 and 41 and 51

Note: The CENTRAL strategy does not include items 42 to 51

Appendix 2. Embase search strategy

1 'vaginosis, bacterial'/exp
2 (vagin* NEAR/5 bacteri*):ab,ti
3 1 or 2
4 'bacterial infections'/exp
5 (bacteri* NEAR/5 infection*):ab,ti
6 4 or 5
7 'vaginitis'/exp
8 vaginiti*:ab,ti
9 vaginosis*:ab,ti
10 colpitis*:ab,ti
11 kolpitis*:ab,ti 56
12 or/7‐11
13 6 and 12
14 3 or 13
15 (antibacterial NEAR/5 therapy):ab,ti
16 (antibacterial NEAR/5 treatment):ab,ti
17 (antimicrobial NEAR/5 therapy):ab,ti
18 (antimicrobial NEAR/5 treatment):ab,ti
19 or/15‐18
20 'anti‐infective agents'/exp
21 ('anti infective' NEAR/5 agent*):ab,ti
22 (antiinfective NEAR/5 agent*):ab,ti
23 microbicide*:ab,ti
24 ('anti microbial' NEAR/5 agent*):ab,ti
25 (antimicrobial NEAR/5 agent*):ab,ti
26 'anti‐bacterial agents'/exp
27 antibiotic*:ab,ti
28 ('anti bacterial' NEAR/5 agent*):ab,ti
29 (antibacterial NEAR/5 agent*):ab,ti
30 bacteriocid*:ab,ti
31 or/20‐30
32 'therapeutics'/exp
33 therap*:ab,ti
34 treatment*:ab,ti
35 or/32‐34
36 31 and 35
37 19 OR 36
38 (sexual NEAR/5 partner*):ab,ti
39 (multiple NEAR/5 partners):ab,ti
40 38 or 39
41 'randomised controlled trial'/exp
42 'single blind procedure'/exp
43 'double blind procedure'/exp
44 'crossover procedure'/exp
45 or/41‐44
46 random*:ab,ti
47 placebo*:ab,ti
48 allocat*:ab,ti
49 crossover*:ab,ti
50 'cross over':ab,ti
51 trial:ti
52 (doubl* NEXT/1 blind*):ab,ti
53 or/46‐53
54 45 or 53
55 'animal'/de
56 'animal experiment'/de
57 'nonhuman'/de
58 or/55‐57
59 'human'/de
60 58 and 59
61 58 not 60
62 54 not 61
63 37 and 40 and 62

Appendix 3. LILACS search strategy

(mh:(vaginosis, bacterial)) OR (ti:(vaginosis)) OR (ab:(vaginosis)) AND db:("LILACS")

RCTs filter:

((PT:"ensayo clinico controlado aleatorio" OR PT:"ensayo clinico controlado" OR PT:"estudio multicéntrico" OR MH:"ensayos clinicos controlados aleatorios como asunto" OR MH:"ensayos clinicos controlados como asunto" OR MH:"estudios multicéntricos como asunto" OR MH:"distribución aleatoria" OR MH:"método doble ciego" OR MH:"metodo simple‐ciego") OR ((ensaio$ OR ensayo$ OR trial$) AND (azar OR acaso OR placebo OR control$ OR aleat$ OR random$ OR enmascarado$ OR simpleciego OR ((simple$ OR single OR duplo$ OR doble$ OR double$) AND (cego OR ciego OR blind OR mask))) AND clinic$)) AND NOT (MH:animales OR MH:conejos OR MH:ratones OR MH:ratas OR MH:primates OR MH:perros OR MH:gatos OR MH:porcinos OR PT:"in vitro")

Appendix 4. Web of Science search strategy

(TS=("vaginosis")) AND TS=(partner*) AND TI=(trial)

Appendix 5. ClinicalTrials.gov search strategy

vaginosis AND partner

Appendix 6. World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search strategy

vaginosis AND partner

Appendix 7. Cochrane Sexually Transmitted Infection Group's Specialized Register search strategy

1 (vaginosis:AB) AND (INREGISTER)
2 (vaginosis:TI) AND (INREGISTER)
3 (partner:AB) AND (INREGISTER)
4 (partner:TI) AND (INREGISTER)
5 (1 OR 2) AND ( 3 OR 4)

Study flow diagram.
Figures and Tables -
Figure 1

Study flow diagram.

'Risk of bias' graph: review authors' judgements about each 'Risk of bias' item presented as percentages across all included studies.
Figures and Tables -
Figure 2

'Risk of bias' graph: review authors' judgements about each 'Risk of bias' item presented as percentages across all included studies.

'Risk of bias' summary: review authors' judgements about each 'Risk of bias' item for each included study.
Figures and Tables -
Figure 3

'Risk of bias' summary: review authors' judgements about each 'Risk of bias' item for each included study.

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.2 Recurrence of BV after the fourth week.
Figures and Tables -
Figure 4

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.2 Recurrence of BV after the fourth week.

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.3 Clinical improvement during the first week.
Figures and Tables -
Figure 5

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.3 Clinical improvement during the first week.

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.4 Clinical improvement between the first and fourth week.
Figures and Tables -
Figure 6

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.4 Clinical improvement between the first and fourth week.

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.5 Clinical improvement after the fourth week.
Figures and Tables -
Figure 7

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.5 Clinical improvement after the fourth week.

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.6 Symptomatic improvement during the first week.
Figures and Tables -
Figure 8

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.6 Symptomatic improvement during the first week.

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.9 Minor adverse events during therapy in sexual partner.
Figures and Tables -
Figure 9

Forest plot of comparison: 1 Any antibiotic treatment versus placebo, outcome: 1.9 Minor adverse events during therapy in sexual partner.

Comparison 1 Any antibiotic treatment versus placebo, Outcome 1 Recurrence of BV between the first and fourth week.
Figures and Tables -
Analysis 1.1

Comparison 1 Any antibiotic treatment versus placebo, Outcome 1 Recurrence of BV between the first and fourth week.

Comparison 1 Any antibiotic treatment versus placebo, Outcome 2 Recurrence of BV after the fourth week.
Figures and Tables -
Analysis 1.2

Comparison 1 Any antibiotic treatment versus placebo, Outcome 2 Recurrence of BV after the fourth week.

Comparison 1 Any antibiotic treatment versus placebo, Outcome 3 Clinical improvement during the first week.
Figures and Tables -
Analysis 1.3

Comparison 1 Any antibiotic treatment versus placebo, Outcome 3 Clinical improvement during the first week.

Comparison 1 Any antibiotic treatment versus placebo, Outcome 4 Clinical improvement between the first and fourth week.
Figures and Tables -
Analysis 1.4

Comparison 1 Any antibiotic treatment versus placebo, Outcome 4 Clinical improvement between the first and fourth week.

Comparison 1 Any antibiotic treatment versus placebo, Outcome 5 Clinical improvement after the fourth week.
Figures and Tables -
Analysis 1.5

Comparison 1 Any antibiotic treatment versus placebo, Outcome 5 Clinical improvement after the fourth week.

Comparison 1 Any antibiotic treatment versus placebo, Outcome 6 Symptomatic improvement during the first week.
Figures and Tables -
Analysis 1.6

Comparison 1 Any antibiotic treatment versus placebo, Outcome 6 Symptomatic improvement during the first week.

Comparison 1 Any antibiotic treatment versus placebo, Outcome 7 Symptomatic improvement between the first and fourth week.
Figures and Tables -
Analysis 1.7

Comparison 1 Any antibiotic treatment versus placebo, Outcome 7 Symptomatic improvement between the first and fourth week.

Comparison 1 Any antibiotic treatment versus placebo, Outcome 8 Symptomatic improvement after the fourth week.
Figures and Tables -
Analysis 1.8

Comparison 1 Any antibiotic treatment versus placebo, Outcome 8 Symptomatic improvement after the fourth week.

Comparison 1 Any antibiotic treatment versus placebo, Outcome 9 Minor adverse events during therapy in sexual partner.
Figures and Tables -
Analysis 1.9

Comparison 1 Any antibiotic treatment versus placebo, Outcome 9 Minor adverse events during therapy in sexual partner.

Comparison 2 Any antibiotic treatment versus no intervention, Outcome 1 Recurrence of BV after the fourth week.
Figures and Tables -
Analysis 2.1

Comparison 2 Any antibiotic treatment versus no intervention, Outcome 1 Recurrence of BV after the fourth week.

Comparison 2 Any antibiotic treatment versus no intervention, Outcome 2 Clinical improvement between the first and fourth week.
Figures and Tables -
Analysis 2.2

Comparison 2 Any antibiotic treatment versus no intervention, Outcome 2 Clinical improvement between the first and fourth week.

Comparison 2 Any antibiotic treatment versus no intervention, Outcome 3 Symptomatic improvement after the fourth week.
Figures and Tables -
Analysis 2.3

Comparison 2 Any antibiotic treatment versus no intervention, Outcome 3 Symptomatic improvement after the fourth week.

Comparison 3 Any antibiotic treatment versus placebo (by antibiotic type), Outcome 1 Recurrence of BV after the fourth week.
Figures and Tables -
Analysis 3.1

Comparison 3 Any antibiotic treatment versus placebo (by antibiotic type), Outcome 1 Recurrence of BV after the fourth week.

Comparison 3 Any antibiotic treatment versus placebo (by antibiotic type), Outcome 2 Clinical improvement during the first week.
Figures and Tables -
Analysis 3.2

Comparison 3 Any antibiotic treatment versus placebo (by antibiotic type), Outcome 2 Clinical improvement during the first week.

Comparison 3 Any antibiotic treatment versus placebo (by antibiotic type), Outcome 3 Clinical improvement between the first and fourth week.
Figures and Tables -
Analysis 3.3

Comparison 3 Any antibiotic treatment versus placebo (by antibiotic type), Outcome 3 Clinical improvement between the first and fourth week.

Comparison 3 Any antibiotic treatment versus placebo (by antibiotic type), Outcome 4 Clinical improvement after the fourth week.
Figures and Tables -
Analysis 3.4

Comparison 3 Any antibiotic treatment versus placebo (by antibiotic type), Outcome 4 Clinical improvement after the fourth week.

Comparison 3 Any antibiotic treatment versus placebo (by antibiotic type), Outcome 5 Minor adverse events during therapy in sexual partner.
Figures and Tables -
Analysis 3.5

Comparison 3 Any antibiotic treatment versus placebo (by antibiotic type), Outcome 5 Minor adverse events during therapy in sexual partner.

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 1 Clinical improvement during the first week.
Figures and Tables -
Analysis 4.1

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 1 Clinical improvement during the first week.

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 2 Clinical improvement between the first and fourth week.
Figures and Tables -
Analysis 4.2

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 2 Clinical improvement between the first and fourth week.

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 3 Clinical improvement after the fourth week.
Figures and Tables -
Analysis 4.3

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 3 Clinical improvement after the fourth week.

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 4 Symptomatic improvement during the first week.
Figures and Tables -
Analysis 4.4

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 4 Symptomatic improvement during the first week.

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 5 Symptomatic improvement between the first and fourth week.
Figures and Tables -
Analysis 4.5

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 5 Symptomatic improvement between the first and fourth week.

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 6 Minor adverse events during therapy in sexual partner.
Figures and Tables -
Analysis 4.6

Comparison 4 Any antibiotic treatment versus placebo (by dose), Outcome 6 Minor adverse events during therapy in sexual partner.

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 1 Recurrence of BV after the fourth week.
Figures and Tables -
Analysis 5.1

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 1 Recurrence of BV after the fourth week.

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 2 Clinical improvement during the first week.
Figures and Tables -
Analysis 5.2

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 2 Clinical improvement during the first week.

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 3 Clinical improvement between the first and fourth week.
Figures and Tables -
Analysis 5.3

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 3 Clinical improvement between the first and fourth week.

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 4 Clinical improvement after the fourth week.
Figures and Tables -
Analysis 5.4

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 4 Clinical improvement after the fourth week.

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 5 Symptomatic improvement during the first week.
Figures and Tables -
Analysis 5.5

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 5 Symptomatic improvement during the first week.

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 6 Symptomatic improvement between the first and fourth week.
Figures and Tables -
Analysis 5.6

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 6 Symptomatic improvement between the first and fourth week.

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 7 Symptomatic improvement after the fourth week.
Figures and Tables -
Analysis 5.7

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 7 Symptomatic improvement after the fourth week.

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 8 Minor adverse events during therapy in sexual partner.
Figures and Tables -
Analysis 5.8

Comparison 5 Any antibiotic treatment versus placebo (attrition bias), Outcome 8 Minor adverse events during therapy in sexual partner.

Summary of findings for the main comparison. Any antibiotic treatment versus placebo

Any antibiotic treatment versus placebo for the sexual partners of woman with bacterial vaginosis

Patient or population: sexual partners of women with bacterial vaginosis
Setting: outpatient clinic
Intervention: any antibiotic treatment
Comparison: placebo

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Risk with placebo

Risk with any antibiotic treatment

Recurrence

follow‐up 4 to 12 weeks

Study population

RR 1.00
(0.67 to 1.52)

372
(3 RCTs)

⊕⊝⊝⊝
very low1,2

196 per 1000

196 per 1000
(131 to 297)

Clinical improvement

follow‐up 1 to 4 weeks

Study population

RR 1.02
(0.94 to 1.11)

590
(3 RCTs)

⊕⊕⊕⊕
high

778 per 1000

794 per 1000
(731 to 864)

Clinical improvement

follow‐up 4 to 12 weeks

Study population

RR 0.98
(0.90 to 1.07)

572
(4 RCTs)

⊕⊕⊕⊕
high

778 per 1000

762 per 1000
(700 to 832)

Symptomatic improvement

during the first week

Study population

RR 1.06
(1.00 to 1.12)

577
(3 RCTs)

⊕⊕⊕⊕
high

863 per 1000

914 per 1000
(863 to 966)

Symptomatic improvement

follow‐up 1 to 4 weeks

Study population

RR 0.93
(0.84 to 1.03)

444
(2 RCTs)

⊕⊕⊕⊕
high

801 per 1000

745 per 1000
(673 to 825)

Symptomatic improvement

follow‐up 4 to 12 weeks

Study population

RR 1.03
(0.90 to 1.17)

296
(2 RCTs)

⊕⊕⊕⊕
high

743 per 1000

766 per 1000
(669 to 870)

Minor adverse events in sexual partner
follow‐up: 1 to 12 weeks

Study population

RR 2.55
(1.55 to 4.18)

477
(3 RCTs)

⊕⊕⊝⊝
low3

80 per 1000

204 per 1000
(124 to 335)

*The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
Abbreviations: CI: confidence interval; RR: risk ratio; OR: odds ratio.

GRADE Working Group grades of evidence
High quality: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: we are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality: our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.
Very low quality: we have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.

1Downgraded by 1 level for significant imprecision as the 95% CI was below 0.75 and over 1.25.
2Downgraded by 2 levels for imprecision as the 95% CI crosses through 0.75 and 1.25 and OIS is not achieved.
3Downgraded by 2 levels for imprecision because the Optimal information size (OIS) was not achieved.

Figures and Tables -
Summary of findings for the main comparison. Any antibiotic treatment versus placebo
Summary of findings 2. Any antibiotic treatment versus no intervention

Any antibiotic treatment versus no intervention

Patient or population: sexual partners of women with bacterial vaginosis
Setting: outpatient clinic
Intervention: any antibiotic treatment
Comparison: no intervention

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Risk with no intervention

Risk with any antibiotic treatment

Recurrence

follow‐up 4 to 12 weeks

Study population

RR 1.71
(0.65 to 4.55)

51
(1 RCT)

⊕⊝⊝⊝
very low1,2

194 per 1000

333 per 1000
(126 to 885)

Clinical improvement

follow‐up 1 to 4 weeks

Study population

RR 0.93
(0.70 to 1.25)

152
(2 RCTs)

⊕⊝⊝⊝
very low1,2,3

851 per 1000

792 per 1000
(596 to 1000)

Symptomatic improvement

follow‐up 4 to 12 weeks

Study population

RR 0.66
(0.39 to 1.11)

70
(1 RCT)

⊕⊝⊝⊝
very low1,2

630 per 1000

416 per 1000
(246 to 700)

*The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
Abbreviations: CI: confidence interval; RR: risk ratio; OR: odds ratio.

GRADE Working Group grades of evidence
High quality: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: we are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality: our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.
Very low quality: we have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.

1Downgraded by 2 levels due to imprecision as OIS was not achieved and the 95% CI crosses through 0.75 and 1.25.
2Downgraded by 2 levels as there were some limitations on blinding and incomplete outcome data domains.
3Downgraded by 1 level for substantial heterogeneity (I² statistic is greater than 40%).

Figures and Tables -
Summary of findings 2. Any antibiotic treatment versus no intervention
Summary of findings 3. Any antibiotic treatment versus placebo

Any antibiotic treatment versus placebo

Patient or population: sexual partners of women with bacterial vaginosis
Setting: outpatient clinics
Intervention: any antibiotic treatment
Comparison: placebo

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Risk with placebo

Risk with any antibiotic treatment

Recurrence
follow‐up 1 to 4 weeks

Study population

RR 1.28
(0.68 to 2.43)

218
(1 RCT)

⊕⊕⊝⊝
low1

132 per 1000

169 per 1000
(90 to 321)

Clinical improvement during the first week

Study population

RR 0.99
(0.96 to 1.03)

712
(4 RCTs)

⊕⊕⊕⊕
high

951 per 1000

942 per 1000
(913 to 980)

*The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
Abbreviations: CI: confidence interval; RR: risk ratio; OR: odds ratio.

GRADE Working Group grades of evidence
High quality: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: we are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality: our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.
Very low quality: we have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.

1Downgraded by 2 levels for imprecision as the 95% CI crosses through 0.75 and 1.25 and OIS is not achieved.

Figures and Tables -
Summary of findings 3. Any antibiotic treatment versus placebo
Comparison 1. Any antibiotic treatment versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Recurrence of BV between the first and fourth week Show forest plot

1

218

Risk Ratio (M‐H, Fixed, 95% CI)

1.28 [0.68, 2.43]

2 Recurrence of BV after the fourth week Show forest plot

3

372

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.67, 1.52]

3 Clinical improvement during the first week Show forest plot

4

712

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.96, 1.03]

4 Clinical improvement between the first and fourth week Show forest plot

3

590

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.94, 1.11]

5 Clinical improvement after the fourth week Show forest plot

4

572

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.90, 1.07]

6 Symptomatic improvement during the first week Show forest plot

3

577

Risk Ratio (M‐H, Fixed, 95% CI)

1.06 [1.00, 1.12]

7 Symptomatic improvement between the first and fourth week Show forest plot

2

444

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.84, 1.03]

8 Symptomatic improvement after the fourth week Show forest plot

2

296

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.90, 1.17]

9 Minor adverse events during therapy in sexual partner Show forest plot

3

477

Risk Ratio (M‐H, Fixed, 95% CI)

2.55 [1.55, 4.18]

Figures and Tables -
Comparison 1. Any antibiotic treatment versus placebo
Comparison 2. Any antibiotic treatment versus no intervention

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Recurrence of BV after the fourth week Show forest plot

1

51

Risk Ratio (M‐H, Fixed, 95% CI)

1.71 [0.65, 4.55]

2 Clinical improvement between the first and fourth week Show forest plot

2

152

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.70, 1.25]

3 Symptomatic improvement after the fourth week Show forest plot

1

70

Risk Ratio (M‐H, Fixed, 95% CI)

0.66 [0.39, 1.11]

Figures and Tables -
Comparison 2. Any antibiotic treatment versus no intervention
Comparison 3. Any antibiotic treatment versus placebo (by antibiotic type)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Recurrence of BV after the fourth week Show forest plot

3

372

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.67, 1.52]

1.1 5‐Nitroimidazoles

2

288

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [0.74, 1.84]

1.2 Lincosamides

1

84

Risk Ratio (M‐H, Fixed, 95% CI)

0.53 [0.19, 1.45]

2 Clinical improvement during the first week Show forest plot

4

712

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.96, 1.03]

2.1 5‐Nitroimidazoles

3

574

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.95, 1.03]

2.2 Lincosamides

1

138

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.94, 1.10]

3 Clinical improvement between the first and fourth week Show forest plot

3

590

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.94, 1.11]

3.1 5‐Nitroimidazoles

2

451

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.93, 1.14]

3.2 Lincosamides

1

139

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.87, 1.11]

4 Clinical improvement after the fourth week Show forest plot

4

572

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.90, 1.07]

4.1 5‐Nitroimidazoles

3

433

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.90, 1.08]

4.2 Lincosamides

1

139

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.78, 1.22]

5 Minor adverse events during therapy in sexual partner Show forest plot

3

477

Risk Ratio (M‐H, Fixed, 95% CI)

2.55 [1.55, 4.18]

5.1 5‐Nitroimidazoles

2

339

Risk Ratio (M‐H, Fixed, 95% CI)

2.76 [1.60, 4.77]

5.2 Lincosamides

1

138

Risk Ratio (M‐H, Fixed, 95% CI)

1.75 [0.54, 5.71]

Figures and Tables -
Comparison 3. Any antibiotic treatment versus placebo (by antibiotic type)
Comparison 4. Any antibiotic treatment versus placebo (by dose)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Clinical improvement during the first week Show forest plot

4

712

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.96, 1.03]

1.1 Single

1

241

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.89, 1.03]

1.2 Multiple dose

3

471

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.97, 1.05]

2 Clinical improvement between the first and fourth week Show forest plot

3

590

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.94, 1.11]

2.1 Single

1

233

Risk Ratio (M‐H, Fixed, 95% CI)

1.13 [0.95, 1.35]

2.2 Multiple dose

2

357

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.89, 1.05]

3 Clinical improvement after the fourth week Show forest plot

4

572

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.90, 1.07]

3.1 Single

1

138

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.86, 1.18]

3.2 Multiple dose

3

434

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.88, 1.09]

4 Symptomatic improvement during the first week Show forest plot

3

577

Risk Ratio (M‐H, Fixed, 95% CI)

1.06 [1.00, 1.12]

4.1 Single

1

241

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.94, 1.12]

4.2 Multiple dose

2

336

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [1.01, 1.18]

5 Symptomatic improvement between the first and fourth week Show forest plot

2

444

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.84, 1.03]

5.1 Single

1

232

Risk Ratio (M‐H, Fixed, 95% CI)

0.95 [0.83, 1.08]

5.2 Multiple dose

1

212

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.78, 1.06]

6 Minor adverse events during therapy in sexual partner Show forest plot

3

477

Risk Ratio (M‐H, Fixed, 95% CI)

2.55 [1.55, 4.18]

6.1 Single

2

339

Risk Ratio (M‐H, Fixed, 95% CI)

2.76 [1.60, 4.77]

6.2 Multiple dose

1

138

Risk Ratio (M‐H, Fixed, 95% CI)

1.75 [0.54, 5.71]

Figures and Tables -
Comparison 4. Any antibiotic treatment versus placebo (by dose)
Comparison 5. Any antibiotic treatment versus placebo (attrition bias)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Recurrence of BV after the fourth week Show forest plot

3

372

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.67, 1.52]

1.1 Low risk

1

98

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.48, 1.92]

1.2 Unclear risk

2

274

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.62, 1.71]

2 Clinical improvement during the first week Show forest plot

4

712

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.96, 1.03]

2.1 Low risk

2

342

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.93, 1.05]

2.2 Unclear risk

2

370

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.96, 1.03]

3 Clinical improvement between the first and fourth week Show forest plot

3

590

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.94, 1.11]

3.1 Low risk

1

233

Risk Ratio (M‐H, Fixed, 95% CI)

1.13 [0.95, 1.35]

3.2 Unclear risk

2

357

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.89, 1.05]

4 Clinical improvement after the fourth week Show forest plot

4

572

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.90, 1.07]

4.1 Low risk

2

243

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.90, 1.17]

4.2 Unclear risk

2

329

Risk Ratio (M‐H, Fixed, 95% CI)

0.95 [0.84, 1.07]

5 Symptomatic improvement during the first week Show forest plot

3

577

Risk Ratio (M‐H, Fixed, 95% CI)

1.06 [1.00, 1.12]

5.1 Low risk

2

348

Risk Ratio (M‐H, Fixed, 95% CI)

1.06 [0.98, 1.14]

5.2 Unclear risk

1

229

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.97, 1.17]

6 Symptomatic improvement between the first and fourth week Show forest plot

2

444

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.84, 1.03]

6.1 Low risk

1

232

Risk Ratio (M‐H, Fixed, 95% CI)

0.95 [0.83, 1.08]

6.2 Unclear risk

1

212

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.78, 1.06]

7 Symptomatic improvement after the fourth week Show forest plot

2

296

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.90, 1.17]

7.1 Low risk

1

107

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.83, 1.29]

7.2 Unclear risk

1

189

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.87, 1.20]

8 Minor adverse events during therapy in sexual partner Show forest plot

3

477

Risk Ratio (M‐H, Fixed, 95% CI)

2.55 [1.55, 4.18]

8.1 Low risk

2

339

Risk Ratio (M‐H, Fixed, 95% CI)

2.76 [1.60, 4.77]

8.2 Unclear risk

1

138

Risk Ratio (M‐H, Fixed, 95% CI)

1.75 [0.54, 5.71]

Figures and Tables -
Comparison 5. Any antibiotic treatment versus placebo (attrition bias)