Bacterial vaginosis: Efficacy and safety of intravaginal metronidazole treatment

Livengood, Charles H.; McGregor, James A.; Soper, David E.; Newton, Edward R.; Thomason, Jessica L.

doi:10.1016/s0002-9378(94)70278-0

Cited by 60 publications

(28 citation statements)

References 16 publications

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“…Therefore, sulfonamides, tetracycline, or ampicillin were indicated for the treatment of BV [1; see ref. 23], but these drugs were not effective [9]. MTN has recent ly proved to be effective [9] which appears to be a result of its activity against anaerobic bacteria associated with BV [21].…”

Section: Resultsmentioning

confidence: 99%

“…BV is characterized by a shift of the normal vaginal flora dominated by Lactobacillus to a flora with increased quantities of Gardnerella vaginalis and anaerobic bacteria [1][2][3][4][5][6][7][8]. While BV is a locally symptomatic dis ease with the absence of inflammation of the vaginal epithelium, vaginal treatment pro vides more chances than does oral antimicro-bial use [9][10][11][12][13]. Additionally, oral therapy had been restricted because of adverse effects.…”

Section: Introductionmentioning

confidence: 99%

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Comparative Study on Vaginal or Oral Treatment of Bacterial Vaginosis

Mikamo

Kawazoe²,

Izumi³

et al. 1997

Chemotherapy

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The bacteriological epidemiology of bacterial vaginosis (BV) and the efficacy of vaginal or oral treatment of BV with clindamycin (CLDM) were investigated. The epidemiology of BV was investigated in 100 symptomatic women before CLDM therapy. Two groups consisting of 50 patients each with the diagnosis of symptomatic BV were treated with either oral administration of 450 mg CLDM three times daily or 2% CLDM phosphate in vaginal cream (self-made) 5 g once a day, for 7 days. There was no significant difference in efficacy among vaginal and oral therapies with CLDM. Vulvovaginal irritation occurred in 3 patients orally treated and in 1 patient vaginally treated. Gastrointestinal disturbances were observed in 4 orally treated patients. A slight abnormal elevation of the glutamine-oxaloacetic transaminase level was also found in 1 patient orally treated. Since there were no statistically significant differences in efficacy rates between vaginal and oral CLDM treatments, we favor vaginal treatment of BV, based on less adverse effects.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative Study on Vaginal or Oral Treatment of Bacterial Vaginosis

Mikamo

Kawazoe²,

Izumi³

et al. 1997

Chemotherapy

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“…Pregnant African Americans have increased prevalence of BV compared to other race/ethnicity groups. 10,11,26,27 Antenatal BV can recur and/or persist despite treatment, 9,32,33 thus lending credibility to the inclusion of previous BV diagnoses in the index pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…Further complicating the situation is the fact that 12% to 50% of untreated antenatal BV cases resolve spontaneously, 11,35,36 and 9% to 20% of antenatal BV can recur and/or persist 4 to 12 gestational weeks later despite treatment. 9,32,33 Self-reported and clinician-identified vaginal symptoms at the time of enrollment would have helped to better assess the interrelationships between symptomatology, clinician-initiated BV testing, and Gram stain BV results. This information would enhance our assessment of the value of our scoring system and possibly add to our understanding of typical BV symptoms during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Risk Score for Antenatal Bacterial Vaginosis: BV PIN Points

et al. 2002

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“…Clinicians use various regimens for treating BV and a current treatment strategy includes the administration of antibiotics such as metronidazole or clindamycin, either orally or topically [52,53]. Although many women respond to antibiotics, BV recurs in 11–29% of women at 1 month [52,54,55] and an adherent G . vaginalis biofilm persists after the antibiotic therapy [56].…”

Section: Discussionmentioning

confidence: 99%

Bacterial biota of women with bacterial vaginosis treated with lactoferrin: an open prospective randomized trial

Pino

Giunta

Randazzo

et al. 2017

Microbial Ecology in Health and Disease

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Background: Bacterial vaginosis is the most frequent condition associated to the vaginal microbiota imbalance, affecting about the 40–50% of women in the world. Even if antibiotics are effcetive for bacterial vaginosis treatment a long-term recurrence rates, higher than 70%, is recorded. Lactoferrin is an iron-binding glycoprotein with bacteriostatic and bactericidal properties. It owns the ability to protect the host against infection, by binding and regulating the iron needed for the bacterial proliferation.Objective: The present study was an open prospective randomized trial (registration no. SHI-EVE-2014.01) aimed at characterizing the bacterial biota of women affected by bacterial vaginosis (BV) and assessing the effects of two different lactoferrin concentrations (100 mg and 200 mg vaginal pessaries) on the composition and dynamics of the vaginal bacterial biota.Design: Sixty women with BV were recruited and randomized into two groups to receive lactoferrin pessaries for 10 days. Clinical evaluation was based on Amsel criteria and Nugent scores. Culture-dependent methods and Ion Torrent PGM sequencing of the 16S rRNA gene were applied to study in depth the overall structure of the vaginal bacterial biota and its dynamics during the treatment.Results: Vaginal lactoferrin administration modified the vaginal microbiota composition in patients with BV. During treatment, both 100 mg and 200 mg lactoferrin vaginal pessaries significantly decreased the occurrence of bacteria associated with BV, such as Gardnerella, Prevotella, and Lachnospira, and increased the occurrence of Lactobacillus species. The bacterial biota balance was maintained up to 2 weeks after treatment only in women treated with 200 mg lactoferrin pessaries.Conclusions: This study indicates that lactoferrin could be proposed as an alternative therapeutic approach for BV. Our data showed, for the first time, the dominance of Lactobacillus helveticus species during and after vaginal lactoferrin treatment.

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Bacterial vaginosis: Efficacy and safety of intravaginal metronidazole treatment

Cited by 60 publications

References 16 publications

Comparative Study on Vaginal or Oral Treatment of Bacterial Vaginosis

Comparative Study on Vaginal or Oral Treatment of Bacterial Vaginosis

Risk Score for Antenatal Bacterial Vaginosis: BV PIN Points

Bacterial biota of women with bacterial vaginosis treated with lactoferrin: an open prospective randomized trial

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