The bactericidal action of dequalinium chloride starts within 30–60 minutes of insertion. An increase in bacterial cell permeability causes a loss of enzyme activity and eventually cell death. Relief of bacterial vaginosis symptoms generally occurs within 24—72 hours; however, patients should be advised to complete the full treatment course in order to avoid a relapse.
Latex condoms are not affected by dequalinium chloride but additional forms of contraception should be considered when non-latex condoms, diaphragms and other barrier contraceptives are used. Use of douches, intravaginal soaps and spermicides should be avoided.
Clinical cure rates at 7 days after treatment were 81.5% in women treated with dequalinium and 78.4% in clindamycin-treated women.
The total failure rate (non-responders and recurrences combined) was similar in the two treatment groups. Symptomatic culture-positive vulvovaginal candidosis was less common in patients using dequalinium than in those treated with clindamycin cream (2.5% vs 7.7%; p=0.06). There were no significant differences between the numbers of women in each group showing symptoms of vulvovaginal candidosis or positive cultures for Candida spp.
The most commonly reported adverse reactions in patients treated with dequalinium were vaginal discharge and vulvovaginal pruritus.
Dequalinium is currently available in lozenge form for treatment of severe sore throats.