PT  - JOURNAL ARTICLE
AU  - Jeanne M Ferrante
AU  - Dionne Y Mayhew
AU  - Seth Goldberg
AU  - Laurie Woodard
AU  - Cynthia Selleck
AU  - Richard G Roetzheim
TI  - Empiric treatment of minimally abnormal papanicolaou smears with 0.75% metronidazole vaginal gel.
DP  - 2002 Sep 01
TA  - The Journal of the American Board of Family Practice
PG  - 347--354
VI  - 15
IP  - 5
4099  - http://www.jabfm.org/content/15/5/347.short
4100  - http://www.jabfm.org/content/15/5/347.full
SO  - J Am Board Fam Med2002 Sep 01; 15
AB  - BACKGROUND The purpose of this study was to compare the efficacy of 0.75% metronidazole vaginal gel with no treatment in patients who have had a minimally abnormal Papanicolaou smear.METHODS One hundred forty-five patients whose initial Papanicolaou smears were limited by inflammation or benign cellular changes, reactive cellular changes, or atypical squamous cells of undetermined significance that did not favor a neoplastic process were randomized to 5 days of treatment with 0.75% metronidazole vaginal gel or to a control group receiving no treatment. Papanicolaou smears were repeated after 3 to 4 months.RESULTS Cytologic findings of the follow-up Papanicolaou smears were normal in 61 of 114 (54%) of patients. Sixty-two percent (n = 37) of the Papanicolaou smears in the control group converted to normal on follow-up, whereas 44% (n = 24) of the Papanicolaou smears in the treatment group converted to normal (P = .07). Only one follow-up Papanicolaou smear worsened to low-grade squamous intraepithelial lesion. In no subgroup was treatment effective.CONCLUSIONS Empiric treatment for an asymptomatic, minimally abnormal Papanicolaou smear with 0.75% metronidazole vaginal gel before a repeated cytologic examination did not improve the rate of reversion to normal cytologic findings.