Topical Kanamycin: an Effective Therapeutic Option in Aerobic Vaginitis

Abstract

Eighty-one patients with clinical diagnosis of aerobic vaginitis (AV) were included in the study. The patients were randomized for treatment, 45 with kanamycin (100 mg vaginal ovules for 6 days, consecutively) and 36 with meclocycline (35 mg vaginal ovules for 6 days, consecutively). The patients were examined before starting the study, 1-2 days after treatment and 30 days after the end of the study. At the first follow-up the patients showed different levels of symptom reduction. Reduction in the presence of leukocytes, vaginal mucosa burning and itching were statistically significant in the group treated with kanamycin with respect to the group treated with meclocycline. Moreover, there was also reduced isolation of Enterobacteriaeae (97%) in the group treated with kanamycin versus those treated with meclocycline (76%). At the second follow-up, vaginal homeostasis (normalization of pH and presence of lactobacilli) was more evident in the kanamycin-treated group. In conclusion, our data suggest that the topical use of kanamycin could be considered a specific antibiotic for the therapy of this new pathology.

The Threat of Aerobic Vaginitis to Pregnancy and Neonatal Morbidity

“…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 .…”

Management of Aerobic Vaginitis

“…At the microbiological level, the former pathology does not present an increase of anaerobe microorganisms but an increase in the frequencies of isolation of Gram-positive cocci, such as Streptococcus agalactiae , staphylococci and enterococci, and Gram-negative microorganisms such as Enterobacteriaceae (particularly, Escherichia coli ) ( table 3 ) [7] . All these microorganisms are indicative of enteric bacteria colonization as the consequence of an alteration of the vaginal microbiota [7] . The lactobacillary microbiota then decrease until they finally disappear [9,10] .…”

“…Nevertheless, the co-presence of the following symptoms should be taken into account: objective abnormal yellow vaginal discharge, foul smell (but negativity to KOH test), and elevated vaginal pH ( 1 5) [7,9,10] .…”

A study of aerobic bacterial pathogens associated with vaginitis in reproductive age group women (15-45 years) and their sensitivity pattern

“…13 Other researchers have also reported similar organisms in their study. 14,20,21 9.68% of the vaginal isolates in the present study were β-hemolytic streptococci. Similar rates have been observed by Mumtaz et al 17 The isolation of K pneumoniae and Pseudomonas aeruginosa in AV cases was also reported by other researchers.…”