Reviewer’s report
Title: 
Intravaginal lactic acid gel versus oral metronidazole for treating women
with recurrent bacterial vaginosis: the VITA randomised controlled trial
Version: 
0 
Date: 
04 Sep 2022
Reviewer: 
Werner Mendling
Reviewer's report:
Dear authors,
the pragmatic approach is - as you mention yourselves - on the one hand not as
exact as a double-blind randomized study, but on the other hand reliable, because
the patient's symptoms, controlled by Ison - Hay criteria in a laboratory, are
sufficient to judge over success or failure of treatment and prophylaxis. So, you
show, that treatment of BV is better with metronidazole than with lactic acid. On
the other hand is the prophylaxis of recurrences of BV after successful treatment
with metronidazole as successful as with lactic acid. You show also, that patients
favor lactic acid for prophylaxis, because it is easily available and no antibiotic.
My single recommendation: meanwhile is a second review on lactic acid in BV
published, which could be added (page 6, line 103: Two recent systematic
reviews...
Mendling W, Shazly MAE, Zhang L.
The Role of Lactic Acid in the Management of Bacterial Vaginosis: A
Systematic Literature Review.
Future Pharm 2022; 2, 198-213).
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