OBJECTIVES: To evaluate the efficacy, safety and pharmacoeconomics profile of Chinese patent medicines (CPM) in combination with nitroimidazoles in the treatment of bacterial vaginitis (BV).

METHODS: PubMed, Embase, Cochrane Library, CNKI, Wanfang, VIP and CBM databases was searched to include randomised controlled trials (RCTs) regarding CPM in combination with nitroimidazoles for the treatment of BV from the establishment of the database to October 20, 2023. Literature screening, data extraction and quality assessment were performed by 2 investigators independently. Stata 15.0 software was applied for network meta-analyses, and minimum cost analysis was used for pharmacoeconomics analysis from the perspective of patients.

RESULTS: A total of 64 RCTs involving 7797 patients and 11 kinds of CPM combined with nitroimidazoles regimen were included. The results of network meta-analysis showed that Fuyanping capsule combined regimen was the most effective in terms of total clinical effective rate [RR=1.24,95 % CI (1.07-1.43)]. For the recurrence rate, compound sea buckthorn seed oil suppository combined regimen was the lowest [RR=0.23,95 % CI (0.10-0.51)]. The incidence of adverse events of most CPM except matrine gel [RR=0.30, 95 % CI (0.16-0.58)] combined regimen was similar to nitroimidazoles monotherapy. The cost of Kangfu Xiaoyan Suppository combined regimen was the lowest.

CONCLUSIONS: Based on the evaluation of the efficacy, safety and pharmacoeconomic profile of 11 CPM combined regimen, Kangfu Xiaoyan Suppository combined with nitroimidazoles will be an optimal choice in the treatment of BV .