Nifuratel-Nystatin combination for the treatment of mixed infections of bacterial vaginosis, vulvovaginal candidiasis, and trichomonal vaginitis

Obiero, Jael; Rulisa, Stephen; Ogongo, Paul; Wiysonge, Charles Shey

doi:10.1002/14651858.cd013012

Cited by 9 publications

(8 citation statements)

References 107 publications

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“…bacterial vaginosis, vaginal candidiasis and trichomoniasis vaginalis same is reported by other studies. 15 , 16 The result of this study showed that bacterial vaginosis was the most common vaginal infection followed by vaginal candidiasis while trichomoniasis vaginalis was the least common vaginal infection in pregnant women with VD this is in consistent with other study. 17 …”

Section: Discussionsupporting

confidence: 90%

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Vaginal discharge during pregnancy and associated adverse maternal and perinatal outcomes

Khaskheli

Baloch

et al. 2021

Pak J Med Sci

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Objectives: To observe the effects of vaginal discharge during pregnancy on maternal and fetal outcomes. Methods: This observational study was undertaken form June 2018 to 31 May 2019 period in the Department of Obstetrics and Gynaecology at Liaquat University of Medical and Health Sciences hospital Jamshoro Unit IV. Data were collected from a convenience sample of 85 pregnant women. All the pregnant women with vaginal discharge were included in the study, while the women with bleeding and other medical disorders during pregnancy were excluded. Data was analyzed. Results: Women’s mean age as 27.4 (±4.7) years and most were 28-35 weeks pregnant (n=29, 34%) and primigravida (n=35, 41%). Seventy six women (89%) presented with vaginal discharge while nine women (11%) reported no vaginal discharge. Of those with vaginal discharge,53 women (69.7%) had vaginal infections: bacterial vaginosis (n=21, 39.6%), vaginal candidiasis (n=17, 32.1%) and vaginal trichomoniasis (n=15, 28.3%). Pathological vaginal discharge (PVD) was associated with vaginal irritation (n=30, p<0.0001), vaginal pain (n=50, p<0.0001), fever (n=12, p=0.015), uterine contractions (n=31, p<0.0001), premature membrane rupture (n=29, p<0.0001), abortion (n=13, p=0.009), pre-term delivery (n=24, p<0.0001) and post-partum endometritis (n=19, p=0.0006). PVD was associated with neonatal outcomes i.e. low birth weight (n=24, p<0.0001), low Apgar score at birth (n=22, p=0.0001), neonatal respiratory distress syndrome (n=21, p=0.0002), neonatal intensive care hospitalisation (n=20, p=0.002) and early neonatal death (n=16, p=0.003). Conclusion: Pathological vaginal discharge (PVD) during pregnancy is more frequent and is associated with adverse maternal and perinatal outcomes. doi: https://doi.org/10.12669/pjms.37.5.4187 How to cite this:Khaskheli M, Baloch S, Baloch AS, Shah SGS. Vaginal discharge during pregnancy and associated adverse maternal and perinatal outcomes. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4187 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 90%

“… 29 PVD in pregnant women needs clinical investigation and relevant treatment. 15 Proper management of vaginal infections and PVD during pregnancy may help in reducing the risk of adverse perinatal outcomes. 29 that are very common in low middle income countries(LMICs) such as Pakistan.…”

Section: Discussionmentioning

confidence: 99%

Vaginal discharge during pregnancy and associated adverse maternal and perinatal outcomes

Khaskheli

Baloch

et al. 2021

Pak J Med Sci

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“…In multiple publications it has been reported that the nifuratel -nystatin combination guarantees a wide range of antimicrobial actions with rapid and notable symptomatic relief in patients with mixed vaginal infections of bacterial, fungal and protozoal origin, 30,40,52 such as we have observed in this research. In a Cochrane review published in 2018 54 they recommend that mixed vaginal infections should be treated effectively to reduce suffering and devastating consequences for women. This has led to the development of broad-spectrum antimicrobials, including the nifuratel-nystatin combination.…”

Section: Discussionmentioning

confidence: 99%

Efficacy And Safety of Nifuratel-Nystatin in The Treatment of Mixed Vaginitis, in Pregnant Women From Quindío, 2013-2017. Randomized Clinical Trial

Hoz¹

2022

PWHCIJ

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Introduction: Women with abnormal vaginal discharge usually suffer from bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), trichomonas vaginitis (TV) or any combination of these. Objective: To compare the efficacy and safety of the combination nifuratel-nystatin with metronidazole -nystatin in the treatment of mixed vaginitis in pregnant women, and its adverse effects. Materials and methods: Randomized, double-blind, parallel-group clinical trial in 153 pregnant women, diagnosed with mixed vaginitis; in a complex private medical institution in Armenia (Colombia), between 2013 and 2017. The patients were randomized 1:1 to receive a daily intravginal egg for six days: nifuratel (500mg) - nystatin (200,000 IU) (Group "A") and metronidazole (500mg) - nystatin (100,000 IU) (Group "B"). A follow-up of the healing of symptoms was determined at one week and an evaluation of the microbiological negativization at one month. Safety was assessed based on reports of adverse events. Descriptive statistics were used. Results: The mean age of the population was 27.59±3.71 years. The mean gestational age in group "A" was 18.56±2.87 weeks compared to 19.57±2.95 weeks in group "B" (p=0.87). The clinical cure rates at 7 days in group "A" were 84.61% vs. 81.33% in group "B", (p=0.91) The microbiological negativization at one month was 91.02% in group "A" vs. 86.66% in group "B", (p=0,072) The recurrence rate was 1.28% in group "A" vs. 5.33% in group "B", (p=0.37) Adverse events were present in the metronidazole-nystatin group, which were mild and self-limited. Conclusion: Both drugs have comparable efficacy and similar safety results in the treatment of mixed vaginitis in pregnant women; therefore, they can be used interchangeably. Studies in larger populations with a control group and random assignment are required to provide better evidence regarding this management.

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“…Out findings revealed statistically significant associations between pathological vaginal discharge and common vaginal infections i.e. bacterial vaginosis, vaginal candidiasis and trichomoniasis vaginalis, 21,22 which are commonly found in pregnant women with low education, underprivileged social and economic status and poor hygiene. 6 Most of women participants of our study were recruited during antenatal appointments in the outpatient obstetrics and gynaecology clinics, which are mostly attended by poor families in Pakistan.…”

Section: Common Causes Of Pathological Vaginal Dischargementioning

confidence: 91%

“…Our findings thus provide empirical evidence that pathological vaginal discharge in pregnant women is a serious maternal c health issue, which needs through clinical examination, laboratory investigation and relevant medical treatment and appropriate advice to pregnant women. 22 These approaches especially laboratory investigation for confirmation of infection and abnormal vaginal micro biota should be the main part of routine antenatal care practices in developing countries like Pakistan, because the management only on the basis of signs and symptoms will not give proper cure and there will be increased opportunities for taking unnecessary multi drug regimes. It is therefore imperative that pathological vaginal discharge is differentiated from normal vaginal discharge so that appropriate treatment for the particular type of pathogenic infections is prescribed to improve women's health and pregnancy outcomes, while the women with physiological vaginal discharge could be counselled, assured and advised for good personal hygiene habits and avoidance of unnecessary medication.…”

Section: Adverse Maternal Pregnancy and Neonatal Outcomes Associatedmentioning

confidence: 99%

Is vaginal discharge a natural or pathological problem in pregnant women associated with adverse pregnancy outcomes?: A cross-sectional study

Khaskheli¹,

Baloch²,

Baloch³

et al. 2020

Preprint

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Objective: To differentiate between normal and pathological vaginal discharge (PVD) in pregnant women and to identify causes of and adverse pregnancy outcomes associated with PVD. Design: A cross-sectional study. Setting: Outpatient antenatal clinics. Population / Sample: Pregnant women, Convenience sample (N=85). Methods: Data were collected through history, clinical examination and laboratory investigations. Data analysed by frequencies, descriptive statistics and Chi-Squared tests. Main outcome measures: Vaginal discharge (VD), age, gestation, parity and adverse pregnancy outcomes. Results: Women's mean age was 27.4 (±4.67) years. Majority of women were 26-31 years old (40%), 28-35 weeks pregnant (34%) and primigravida (41%). Of 89% (n=76) women with VD, 32% (n=24) had normal VD and 68% (n=52) PVD. Normal VD was watery (100%) and odourless (96%) while PVD was yellowish curd like (33%) and foul smelling (52%). PVD was significantly associated with bacterial vaginosis (P < 0.0001), candidiasis (P = 0.005) and trichomoniasis (P = 0.018). A higher proportion of women with PVD reported irritation (P < 0.0001), pain (P < 0.0001), uterine contractions (P < 0.0001), premature membrane rupture (P < 0.0001), abortion (P < 0.042), pre-term delivery (P < 0.0001) and post-partum endometritis (P < 0.0001). PVD was also associated with low birth weight (P < 0.0001), low Apgar score at birth (P < 0.0001), respiratory distress syndrome (P < 0.0001), intensive neonatal care hospitalisation (P = 0.001) and early neonatal death (P = 0.002). Conclusions: Vaginal discharge in pregnancy requires early investigation to avoid any adverse fetomaternal outcomes associated with pathological vaginal discharge.

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Nifuratel-Nystatin combination for the treatment of mixed infections of bacterial vaginosis, vulvovaginal candidiasis, and trichomonal vaginitis

Cited by 9 publications

References 107 publications

Vaginal discharge during pregnancy and associated adverse maternal and perinatal outcomes

Vaginal discharge during pregnancy and associated adverse maternal and perinatal outcomes

Efficacy And Safety of Nifuratel-Nystatin in The Treatment of Mixed Vaginitis, in Pregnant Women From Quindío, 2013-2017. Randomized Clinical Trial

Is vaginal discharge a natural or pathological problem in pregnant women associated with adverse pregnancy outcomes?: A cross-sectional study

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