OBJECTIVE: This study was undertaken to evaluate antimicrobial susceptibility of vaginal anaerobic bacteria before and after treatment of bacterial vaginosis. STUDY DESIGN: A randomized clinical trial of 119 nonpregnant women with bacterial vaginosis receiving eitherintravaginal metronidazolefor 5 days orclindamycin for 3 days was performed. Women had 1 baseline and 3 follow-up visits at which quantitative vaginal cultures were performed. Anaerobic isolates underwent antimicrobial susceptibility testing. RESULTS: Complete susceptibility data was available on 95 women (47metronidazole and 48 clindamycin). Of 1059 anaerobic bacterial isolates, less than 1% demonstrated resistance to metronidazole. In contrast, 17% demonstrated baseline clindamycin resistance, and 53% demonstrated resistance to clindamycin after therapy. Women exposed to clindamycin (but not metronidazole) had high frequencies (80%) of clindamycin-resistant anaerobic bacteria that persisted for 90 days after treatment. CONCLUSION: Treatment of bacterial vaginosis with clindamycin is associated with marked evidence of antimicrobial resistance among vaginal anaerobic bacteria. This may increase the vaginal reservoir of macrolide-resistant bacteria.
RCT Entities:
OBJECTIVE: This study was undertaken to evaluate antimicrobial susceptibility of vaginal anaerobic bacteria before and after treatment of bacterial vaginosis. STUDY DESIGN: A randomized clinical trial of 119 nonpregnant women with bacterial vaginosis receiving either intravaginal metronidazole for 5 days or clindamycin for 3 days was performed. Women had 1 baseline and 3 follow-up visits at which quantitative vaginal cultures were performed. Anaerobic isolates underwent antimicrobial susceptibility testing. RESULTS: Complete susceptibility data was available on 95 women (47 metronidazole and 48 clindamycin). Of 1059 anaerobic bacterial isolates, less than 1% demonstrated resistance to metronidazole. In contrast, 17% demonstrated baseline clindamycin resistance, and 53% demonstrated resistance to clindamycin after therapy. Women exposed to clindamycin (but not metronidazole) had high frequencies (80%) of clindamycin-resistant anaerobic bacteria that persisted for 90 days after treatment. CONCLUSION: Treatment of bacterial vaginosis with clindamycin is associated with marked evidence of antimicrobial resistance among vaginal anaerobic bacteria. This may increase the vaginal reservoir of macrolide-resistant bacteria.
Authors: Jennifer E Balkus; Barbra A Richardson; Kishorchandra Mandaliya; James Kiarie; Walter Jaoko; Jeckoniah O Ndinya-Achola; Jeanne Marrazzo; Carey Farquhar; R Scott McClelland Journal: J Infect Dis Date: 2011-07-15 Impact factor: 5.226
Authors: Jack D Sobel; Navkiranjot Kaur; Nicole A Woznicki; Dina Boikov; Tina Aguin; Gurveer Gill; Robert A Akins Journal: J Clin Microbiol Date: 2019-04-26 Impact factor: 5.948
Authors: Jeanne M Marrazzo; Katherine K Thomas; Tina L Fiedler; Kathleen Ringwood; David N Fredricks Journal: Ann Intern Med Date: 2008-07-01 Impact factor: 25.391