Dequalinium for BV: Early Clinical Cure and Four-Week Symptoms

A BV treatment’s success rate needs a definition and a date. With dequalinium chloride, early clinical findings, later symptoms and laboratory findings give different answers.

The 2024 trial checked clinical signs shortly after treatment

This masked European trial randomized 151 women and treated 147, all premenopausal and White. It compared six days of 10-mg vaginal dequalinium chloride with seven days of oral metronidazole. Clinical cure required resolution of abnormal discharge, the odor test and clue cells on microscopy.¹

At 7–11 days after treatment began, cure was 64/69 (92.8%) with dequalinium versus 69/74 (93.2%) with metronidazole. Dequalinium met the prespecified 15-percentage-point noninferiority margin, a comparison allowance that does not establish identical effects.¹

At 20–40 days, clinical cure was 55/69 (79.7%) versus 62/71 (87.3%); that noninferiority analysis was inconclusive. Follow-up was short, and recruitment ended early. Medinova funded the trial and participated in design, analysis and publication.¹

DEVA asked about symptoms at four weeks

The 2026 DEVA conference abstract reports 1,311 randomized participants in an open-label UK trial. With outcomes available, 310/592 (52.4%) on dequalinium and 294/575 (51.1%) on usual-care antibiotics reported symptom resolution at four weeks. The adjusted difference met the trial’s 10-percentage-point noninferiority margin. Most antibiotic recipients received oral metronidazole.²

The protocol defined success as symptom resolution without additional treatment, and microscopy was a subgroup assessment. The study was funded through NIHR’s Health Technology Assessment programme.³

The abstract reports microscopic resolution of 55.6% with dequalinium versus 71.7% with antibiotics. It also reports fewer side effects with dequalinium. These are abstract-level findings; the short report supplies less detail than a full trial paper.²

The studies used different assessments and populations. These percentages cannot track one person’s odds from 93% to 52%, or equate symptom relief with a particular laboratory finding.¹²

What the UK prescription information adds

Fluomizin is a UK prescription vaginal tablet for BV, with a labeled six-day course. Its prescribing information notes insufficient efficacy and safety data above age 55, and lists vaginal candidiasis, itching and burning among common adverse effects.⁴

It advises medical review if symptoms persist or recur, rather than automatically repeating treatment. Longer treatment or higher daily doses can increase the risk of vaginal ulceration. Pregnancy use should be limited to clear need. These are UK product instructions; confirm the proposed product and local prescribing rules.⁴

Make the follow-up question specific

Ask: “Are we checking whether my symptoms have settled, repeating a test, or both? When should I return if discharge or odor comes back?”

Bring the treatment name, dates, missed doses, side effects and the date symptoms returned. The Down-There Log in Down There, Decoded records symptom changes, cycle timing, recent products and treatments tried. Our lactic-acid gel comparison addresses a different nonantibiotic option.