Microbiological/clinical characteristics and validation of topical therapy with kanamycin in aerobic vaginitis: a pilot study

Tempera, G; Bonfiglio, Giovanni; Cammarata, E.; Corsello, S; Cianci, Antonio

doi:10.1016/j.ijantimicag.2003.12.013

Cited by 34 publications

(31 citation statements)

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“…In this study, it was demonstrated that some antibiotics showed poor or no activity against lactobacilli ( table 4 ). Among the antibiotics tested, kanamycin showed the highest MICs being inactive in vitro against lactobacilli; the same features were also demonstrated in an in vivo study by Tempera et al [7,19] .…”

Section: Therapeutic Management Of Aerobic Vaginitissupporting

confidence: 69%

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Management of Aerobic Vaginitis

Tempera

Furneri²

2010

Gynecol Obstet Invest

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Aerobic vaginitis is a new nonclassifiable pathology that is neither specific vaginitis nor bacterial vaginosis. The diversity of this microbiological peculiarity could also explain several therapeutic failures when patients were treated for infections identified as bacterial vaginosis. The diagnosis ‘aerobic vaginitis’ is essentially based on microscopic examinations using a phase-contrast microscope (at ×400 magnification). The therapeutic choice for ‘aerobic vaginitis’ should take into consideration an antibiotic characterized by an intrinsic activity against the majority of bacteria of fecal origin, bactericidal effect and poor/absent interference with the vaginal microbiota. Regarding the therapy for aerobic vaginitis when antimicrobial agents are prescribed, not only the antimicrobial spectrum but also the presumed ecological disturbance on the anaerobic and aerobic vaginal and rectal microbiota should be taken into a consideration. Because of their very low impact on the vaginal microbiota, kanamycin or quinolones are to be considered a good choice for therapy.

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Section: Therapeutic Management Of Aerobic Vaginitissupporting

confidence: 69%

“…normalization of clinical signs and symptoms and by colpocytological examination) [7,19] . The presence of enterococci in pathological samples has always been the object of discussion.…”

Section: Therapeutic Management Of Aerobic Vaginitismentioning

confidence: 99%

Management of Aerobic Vaginitis

Tempera

Furneri²

2010

Gynecol Obstet Invest

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“…As with most endogenous infections, species prevalence differs among the different geographical regions with some reporting S. aureus as the most prevalent 85,19,9, followed by E. coli 85,86 Enterococcus 85,87 and GBS 86 . Others report E. coli followed by E. faecalis 88,89 , GBS and Enterobacteriaceae 90 . There is currently no standardized treatment for AV infected mothers to reduce the rate of adverse pregnancy outcomes 18 , although treatment during the second trimester of pregnancy has been advocated 10 .…”

Section: Resultsmentioning

confidence: 99%

The Threat of Aerobic Vaginitis to Pregnancy and Neonatal Morbidity

Kaambo

Africa

2017

Afr J Reprod Health

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Aerobic vaginitis (AV) is an endogenous opportunistic infection brought about by the disruption of the normal vaginal microbiota. Its early diagnosis and treatment during pregnancy may reduce the risk of negative pregnancy outcomes. The aim of this review was to report on the aerobic bacteria most prevalent in AV and to provide evidence of the threat of untreated AV on pregnancy outcomes. More than 300 papers on preterm delivery were extracted from several research domains and filtered to include only AV-associated bacteria such as Staphylococcus aureus, Enterococcus faecalis, Escherichia coli and Group B streptococci and their association with adverse pregnancy outcomes. Due to the diverse sample groups, study techniques and outcomes, a meta-analysis was not conducted. The review revealed that the association of AV with adverse pregnancy outcomes has not been as widely researched as bacterial vaginosis (BV) and needs further investigation. Furthermore, the frequent misdiagnosis of AV coupled with the emerging antimicrobial resistance associated with bacteria implicated in AV and neonatal nosocomial infections pose a problem for prophylaxis and treatment to reduce the risk of maternal and neonatal morbidity and mortality. (Afr J Reprod Health 2017; 21[2]: 109-118). Keywords: Aerobic vaginitis; pregnancy risks; antimicrobial resistance RésuméLa vaginite aérobie (VA) est une infection opportuniste endogène provoquée par la perturbation du microbiota vaginal normal. Son diagnostic précoce et son traitement pendant la grossesse peuvent réduire le risque de résultats négatifs de grossesse. L'objectif de cette revue était de faire un rapport sur les bactéries aérobies les plus répandues en VA et de prouver la menace de la VA non traitée sur les résultats de la grossesse. Plus de 300 articles sur l'accouchement prématuré ont été tirés de plusieurs domaines de recherche et filtrés pour inclure uniquement des bactéries associées à la VA telles que Staphylococcus aureus, Enterococcus faecalis, Escherichia coli et streptocoques du groupe B et leur association avec des résultats de grossesse indésirables. En raison des divers groupes d'échantillons, des techniques d'étude et des résultats, une méta-analyse n'a pas été menée. L'examen a révélé que l'association de la VA avec les résultats de grossesse défavorisés n'a pas été aussi largement étudiée que la vaginose bactérienne (VB) et doit faire l'objet d'une enquête plus approfondie. En outre, le diagnostic erroné de la VA y compris la résistance antimicrobienne émergente associée à une bactérie impliquée dans les infections à vent et nonnéomatologiques constitue un problème pour la prophylaxie et le traitement afin de réduire le risque de morbidité et de mortalité maternelle et néonatale. (Afr J Reprod Health 2017; 21[2]: 109-118).

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“…AV elicits an intense immune response with high levels of interleukin-6, interleukin-1 ␤ and leukemia inhibitory factor in the vaginal fluid [11,13] , and may be a potential cofactor in the pathogenesis of infection-related complications in pregnancy such as cervix shortening, chorioamnionitis, preterm rupture of the membranes and preterm delivery [15][16][17] . Although some treatment trials have shown some success with topical antibiotics like kanamycin, standard therapy is not yet available for AV [18,19] .…”

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confidence: 99%

Effect of Lyophilized Lactobacilli and 0.03 mg Estriol (Gynoflor®) on Vaginitis and Vaginosis with Disrupted Vaginal Microflora: A Multicenter, Randomized, Single-Blind, Active-Controlled Pilot Study

Donders

Bulck²,

Walle

et al. 2010

Gynecol Obstet Invest

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Objectives: To evaluate the efficacy of lyophilized lactobacilli in combination with 0.03 mg estriol when compared to metronidazole in the treatment of bacterial vaginal infections. Setting: Multicenter, randomized, single-blind, active-controlled pilot study in 3 independent gynecological practices in Belgium. Methods: Forty-six, 18- to 50-year-old premenopausal women with a disrupted vaginal flora due to a bacterial vaginal infection (bacterial vaginosis, aerobic vaginitis) were included, provided that fresh phase-contrast microscopy of the vaginal fluid showed lactobacillary flora grade 2B or 3. Patients were given a blinded box with either 12 vaginal tablets of Gynoflor® (study medication) or 6 vaginal suppositories containing 500 mg metronidazole (control medication). Eight efficacy variables were studied to assess the status of the vaginal flora at entry, 3–7 days (control 1), 4–6 (control 2) weeks and 4 months after the end of therapy. Results: At control 1, the combined variables equally improved in the lactobacilli group as in the metronidazole group. At control 2, the lactobacillus preparation showed slightly inferior results when compared to metronidazole. At 4 months, this analysis could not be performed due to low numbers, but analysis of recurrence rate and extra medication needed was not different between both groups. Conclusion: Lyophilized lactobacilli in combination with low-dose estriol are equivalent to metronidazole in the short-term treatment of bacterial vaginal infections, but have less effect after 1 month. Further studies are required to evaluate the long-term efficacy of lactobacilli when applied repeatedly.

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Microbiological/clinical characteristics and validation of topical therapy with kanamycin in aerobic vaginitis: a pilot study

Cited by 34 publications

References 10 publications

Management of Aerobic Vaginitis

Management of Aerobic Vaginitis

The Threat of Aerobic Vaginitis to Pregnancy and Neonatal Morbidity

Effect of Lyophilized Lactobacilli and 0.03 mg Estriol (Gynoflor®) on Vaginitis and Vaginosis with Disrupted Vaginal Microflora: A Multicenter, Randomized, Single-Blind, Active-Controlled Pilot Study

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