Efficacy of oral moxifloxacin for aerobic vaginitis

Abstract

The purpose of this study was to investigate the therapeutic efficacy of oral moxifloxacin for aerobic vaginitis (AV). We also identified factors that are associated with therapeutic efficacy. This prospective study enrolled general gynecological outpatients at Tianjin Medical University General Hospital between September 2012 and May 2014. Women diagnosed with AV (n = 102) were recruited. All enrolled women were treated with oral moxifloxacin, 400 mg once daily for 6 days (one course). Therapeutic efficacy was evaluated based on microscopic criteria, and cure rates were calculated. Women who were microscopically improved (but not cured) received a second course of therapy. Women classified with microscopic failure were treated using other strategies. Univariate and multivariate logistic regression analysis was used to identify factors that may be associated with a cure after one course of therapy. After one course of therapy, 65.7 % (67/102) of women were cured, 29.4 % (30/102) of women were improved (but not cured), 4.9 % (5/102) of women failed to respond to the therapy. After two courses of therapy, 85.3 % (87/102) of women were cured, 9.8 % (10/102) of women were improved, 4.9 % (5/102) of women failed to respond to the therapy, and clinical improvement was achieved in additional women. In the multivariate logistic regression analysis, women with a baseline vaginal pH value of <5.0 had a 3.5-times higher chance of being cured, compared with those with a baseline vaginal pH value of ≥5.0 (OR, 3.503; 95 % CI, 1.278-9.601). Moxifloxacin is an effective therapeutic option for patients with AV. Most women with AV were cured with one course of moxifloxacin. For those with a higher vaginal pH value of ≥5.0 before treatment, two courses of therapy should be considered.

The pathogenesis of prevalent aerobic bacteria in aerobic vaginitis and adverse pregnancy outcomes: a narrative review

“…[ 91 ] conducted in vitro culture experiments and determined susceptibilities to various antibiotics of 1923 vaginal swabs from AV patients, finding that carbapenems and β-lactam-β-lactamase inhibitor combinations were the most effective antibiotics; moreover, as a category B drug, it could be considered for application to AV patients during pregnancy. Studies have shown that moxifloxacin, a fourth-generation quinolone, shows broad-spectrum antibacterial activity, including against gram-positive bacteria, gram-negative bacteria, anaerobic bacteria and atypical organisms such as mycoplasma, chlamydia and legionella, and shows a significant curative effect on nonpregnant AV patients [ 4 , 92 ]. However, as a category C drug, moxifloxacin can decrease foetal body weight and slightly delay foetal skeletal development, so moxifloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus.…”

How to diagnose and treat aerobic and desquamative inflammatory vaginitis

“…In general authors prefer antimicrobials active against aerobic bacteria such as topical clindamycin,4 kanamycin ovules9 or moxifloxacin 10. Atrophy needs treatment with oestrogen replacement 11.…”

Accurate 16S Absolute Quantification Sequencing Revealed Vaginal Microecological Composition and Dynamics During Mixed Vaginitis Treatment With Fufang FuRong Effervescent Suppository

“…The CDC (Centers for Disease Control and Prevention) Sexually Transmitted Infection Treatment Guidelines of 2021 also suggests these treatments (Workowski et al, 2021). For AV, topical vaginal clindamycin or kanamycin or oral other antibacterial drugs that are active against aerobic bacteria such as cefuroxime or moxifloxacin are recommended (Mendling et al, 2016;Wang et al, 2016;Feng et al, 2018). The European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline of 2018 also recommends topical clindamycin as the primary treatment for AV (Sherrard et al, 2018).…”