TITLE: The Efficacy of Vaginal Clindamycin for the Treatment of
Abnormal Genital Tract Flora in Pregnancy

  ABSTRACT:
Objective: To assess the efficacy of 2% clindamycin vaginal cream (CVC) to treat bacterial vaginosis (BV) in
              pregnancy.
  Methods: A prospective, randomized, double-blind, placebo-controlled, tricenter study. Four hundred and four
women with BV on Gram stain at their first antenatal clinic visit were randomized to receive a 3-day course of
2% CVC or placebo. The outcome was assessed using an intention to treat analysis at 3 weeks and 6 weeks
post-treatment according to three different diagnostic methods based on five criteria (Gram stain and all four
elements of clinical composite criteria: vaginal discharge, abnormal vaginal pH, clue cells, amine odor), three
criteria (vaginal pH, clue cells, amine odor) or two criteria (clue cells and amine odor) to reflect stringency of
diagnosis, historical precedence and government agency recommendations respectively.
  Results: Using five diagnostic criteria, 18% of CVC patients were cured and 70.8% either cured and/or improved
compared to 1.6% and 12% of placebo patients respectively (p < 0.0001). Using three diagnostic criteria, 44.8%
of CVC patients were cured and 77.3% were either cured and/or improved compared to 9.3% and 28.8% of
placebo patients respectively (p < 0.0001). Using two diagnostic criteria, 75.0% of CVC patients were cured
compared to 18.0% of placebo patients (p < 0.0001). Recurrence rates in those CVC patients successfully treated
were approximately 6% at 6 weeks post baseline and 10% at 28 to 34 weeks gestation.
  Conclusions:  A 3-day course of CVC appears to be well tolerated by the mother and statistically significantly
more efficacious than placebo in the treatment of BV during the second trimester of pregnancy.

Question: Compared to Placebo what was the result of Clindamycin cream on Cured patients using 3 criteria?
Evidence: Using five diagnostic criteria, 18% of CVC patients were cured and 70.8% either cured and/or improved
compared to 1.6% and 12% of placebo patients respectively (p < 0.0001
Answer: significantly increased