Dequalinium chloride

How it works

It is a cationic surfactant that disrupts the cell membrane and reduces the surface tension of bacterial cells, producing a broad-spectrum antibacterial and antifungal effect against vaginal pathogens.

Prescribing in practice

• Avoid use during menstruation or before the cervix is closed, and do not use in young women who have not yet had their first period, as efficacy and safety depend on appropriate vaginal placement.
• It offers a non-antibiotic option for bacterial vaginosis, which may be useful where antibiotic resistance or intolerance is a concern.
• Soap can inactivate the agent, so concurrent use of soap-based intimate washes should be avoided during treatment.

Monitoring

Routine laboratory monitoring is not required; review the patient if symptoms persist or recur after completing the course.

Counselling the patient

• Insert the tablet high into the vagina, ideally at night when lying down, for the full prescribed course.
• Mild local irritation or discharge can occur and usually settles; seek advice if symptoms worsen.
• Complete the full course even if symptoms improve early.

Evidence & guidelines

Clinical studies have shown dequalinium chloride to be comparable in efficacy to topical antibiotics such as clindamycin for bacterial vaginosis.