High-Dose Vaginal Metronidazole for Recurrent Bacterial Vaginosis—A Pilot Study

Aguin, Tina; Akins, Robert A.; Sobel, Jack D.

doi:10.1097/lgt.0b013e31829a5558

Cited by 19 publications

(12 citation statements)

References 28 publications

(9 reference statements)

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“…14 Clinicians caring for women with BV may consider home screening, 15 probiotics, 16 suppressive antibiotics, or the provision of antibiotics to use when symptoms recur, to minimize delay arising from need for a clinician visit. 17…”

Section: Discussionmentioning

confidence: 99%

Correlates of Bacterial Vaginosis Over Long-Term Follow-Up: Impact of HIV Infection

Massad

Evans

Kang

et al. 2017

AIDS Research and Human Retroviruses

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Correlates of bacterial vaginosis (BV) are poorly understood, especially in HIV infection. In a cohort study, HIV-seropositive and comparison seronegative women were assessed every 6 months during 1994-2015. BV was considered present when three of four Amsel criteria were met. Behavioral characteristics were assessed using structured interviews. Multivariable logistic regression used generalized estimating equation models to determine factors associated with BV. Cumulative incidence of BV over time was assessed using the log-rank test. Among 3,730 women (964 HIV seronegative and 2,766 HIV seropositive) contributing 70,970 visits, BV was diagnosed at 2,586 (14.0%) visits by HIV-seronegative women and 6,224 (11.9%) visits by HIV-seropositive women (p < .0001). The cumulative incidence of BV was 530/964 (55.0%) in HIV-seronegative women and 1,287/2,766 (46.5%) in seropositive women (p < .0001). In adjusted analyses, factors associated with BV were younger age, ethnicity, lower income, less education, recruitment site, recruitment in the 2001-2002 cohort, heavier drinking, current smoking, depression, and sex with a male partner; both hormonal contraception and menopause were negatively associated with BV. Of 533 women with prevalent BV, 228 (42.8%) recurred within a year, while persistent BV was found in 12.8% of participants; neither proportion differed by HIV serostatus. Time trends in the proportion of women with BV at any single visit were not identified. BV is common among women with and at risk for HIV, but HIV infection does not predispose to BV, which is associated instead with behavioral and cultural factors.

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Section: Discussionmentioning

confidence: 99%

Correlates of Bacterial Vaginosis Over Long-Term Follow-Up: Impact of HIV Infection

Massad

Evans

Kang

et al. 2017

AIDS Research and Human Retroviruses

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“…Традиційна схема лікування дозволяє швидко усунути симптоми дисбіозу, тому що антибактеріальні препарати пригнічують патогенну та умовно-патогенну флору. Однак дисбіотичні прояви при цьому посилюються, оскільки одночасно відбувається пригнічення пулу лактобацил, що зумовлює потенціювання загальних процесів дисбактеріозу (рецидиву) (Aguin et al, 2014).…”

Section: таблицяunclassified

Correction of vaginal dysbiosis in mice caused by a film-forming strain Staphylococcus aureus, using bacteriophages and probiotics

Vorobey

Воронкова

Винников

2017

Regul. Mech. Biosyst.

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The complex use of bacteriophages and probiotics is a promising trend in improving prevention and treatment of gynecological lesions. Our study of their influence on the microflora was performed on the model of vaginal dysbiosis of white laboratory mice induced by introduction of a filmforming strain of Staphylococcus aureus. For correction of dysbiosis, staphylococcal bacteriophage liquid, piobacteriophage polyvalent, intesti-bacteriophage liquid and probiotic "Vahilak" were used. For the identification of the microflora of the reproductive tract, samples of biological material from the vagina were obtained by sterile cotton swab and plated on nutrient media to determine the nature and extent of growth of the cultures. The maximal effect was found to occur with the correctional complex "bacteriophage staphylococcal liquid – vahilak" that led to decrease of total microbial number to 4.77 × 104 CFU/ml and to the restoration of the ratio of aerobic to anaerobic bacteria 1 : 52 when indicators of the norm were 4,69 × 104 CFU/ml and 1 : 52. In this case, 24 hours after the last injection of the preparations the amount of microaerophilic and anaerobic lactobacilli had increased by 20.8 and 2.1 times respectively. The frequency of isolation of microaerophilic lactobacilli increased to 100%, and anaerobic – up to 70%. Also the number of staphylococci, streptococci, enterococci, bacilli and enterobacteria decreased by 30.1, 1.1, 1.5, 2.2 and 11.8 times respectively. Also, there was a decrease in the detection rate of enterococci, micrococci and enterobacteria by 10% and bacilli by 20% compared to the control dysbiosis. The number of anaerobic bacteria also underwent significant changes. Thus, the number of fusobacteria decreased by 33.2 times, peptococci – 2.3, peptostreptococci – 6.6 and Bacteroides – 7.9 times, which is almost consistent with indicators of the norm. In addition, the frequency of detection of peptostreptococci decreased by 10%. Therefore, it can be concluded that medical bacteriophages are active against lesions caused by able to film-forming staphylococci, in vivo, so they are appropriate to use in medical practice both independently and in combination with other agents.

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“…12 The high-dose metronidazole regimen suggested improved cure rates in comparison with prior studies in this refractory population and potential for use as a maintenance regimen. In our preceding pilot study in a treatment-resistant population, we found that the short-term clinical cure rate was high with daily intravaginal metronidazole 750 mg for 7 days.…”

mentioning

confidence: 90%

“…12 If symptomatic BV recurred and was confirmed by Amsel criteria (4 of 4), the patient was dropped from the first study and enrolled into the current study. Eighteen women with severe recurrent BV were enrolled.…”

mentioning

confidence: 99%

High-Dose Vaginal Maintenance Metronidazole for Recurrent Bacterial Vaginosis

Aguin¹,

Akins²,

Sobel³

2014

Sexually Transmitted Diseases

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The purpose of this study was to explore the benefit of high-dose intravaginal metronidazole as a maintenance therapy in reducing recurrence rates of bacterial vaginosis (BV). Eighteen women with a history of recurrent BV and symptomatic BV were treated with metronidazole 750 mg suppository intravaginally daily for 7 days. Those in remission by Amsel criteria received metronidazole 750 mg twice weekly for 3 months with further follow-up for 3 months. High-dose metronidazole intravaginally was associated with rare clinical recurrence during the period of use. After cessation of suppression therapy, recurrence was high.

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High-Dose Vaginal Metronidazole for Recurrent Bacterial Vaginosis—A Pilot Study

Abstract: Cure rates for BV were high in this refractory cohort and seemed dose dependent.

Cited by 19 publications

References 28 publications

Correlates of Bacterial Vaginosis Over Long-Term Follow-Up: Impact of HIV Infection

Correlates of Bacterial Vaginosis Over Long-Term Follow-Up: Impact of HIV Infection

Correction of vaginal dysbiosis in mice caused by a film-forming strain Staphylococcus aureus, using bacteriophages and probiotics

High-Dose Vaginal Maintenance Metronidazole for Recurrent Bacterial Vaginosis

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