Bernard J Moncla1, Sharon L Hillier. 1. Department of Obstetrics, Gynecology and Reproductive Sciences, and the Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA 15213-3180, USA. bjm4@pitt.edu
Abstract
OBJECTIVES: To understand why clinical trials failed to demonstrate efficacy of nonoxynol-9 in preventing gonorrhea. GOAL: To test the hypothesis that nonoyxnol-9 failed to prevent acquisition of Neisseria gonorrhoeae because most isolates are resistant to killing by nonoyxnol-9 at the level attainable with intravaginal use. STUDY: The lowest concentrations of nonoxynol-9 required to kill or inhibit growth of clinical isolates of N gonorrhoeae and Lactobacillus were determined. RESULTS: Most strains (17 of 25) of N gonorrhoeae (68%) were resistant to the highest concentration of nonoxynol-9 tested (20%). L crispatus (100%), L jensenii (90%), and L iners (79%) were also resistant to nonoxynol-9. CONCLUSIONS: N gonorrhoeae and H2O2-producing strains of vaginal lactobacilli were not killed by nonoxynol-9 at concentrations greater than those achievable in vivo. Earlier studies that formed the basis for subsequent trials most likely did not detect resistance because too few isolates were evaluated. Large numbers of clinical isolates should be examined before the initiation of clinical trial using microbicidal products.
OBJECTIVES: To understand why clinical trials failed to demonstrate efficacy of nonoxynol-9 in preventing gonorrhea. GOAL: To test the hypothesis that nonoyxnol-9 failed to prevent acquisition of Neisseria gonorrhoeae because most isolates are resistant to killing by nonoyxnol-9 at the level attainable with intravaginal use. STUDY: The lowest concentrations of nonoxynol-9 required to kill or inhibit growth of clinical isolates of N gonorrhoeae and Lactobacillus were determined. RESULTS: Most strains (17 of 25) of N gonorrhoeae (68%) were resistant to the highest concentration of nonoxynol-9 tested (20%). L crispatus (100%), L jensenii (90%), and L iners (79%) were also resistant to nonoxynol-9. CONCLUSIONS: N gonorrhoeae and H2O2-producing strains of vaginal lactobacilli were not killed by nonoxynol-9 at concentrations greater than those achievable in vivo. Earlier studies that formed the basis for subsequent trials most likely did not detect resistance because too few isolates were evaluated. Large numbers of clinical isolates should be examined before the initiation of clinical trial using microbicidal products.
Authors: Lin Wang; Alexandra Beumer Sassi; Dorothy Patton; Charles Isaacs; B J Moncla; Phalguni Gupta; Lisa Cencia Rohan Journal: Drug Dev Ind Pharm Date: 2011-12-10 Impact factor: 3.225
Authors: Courtney A Schreiber; Leslie A Meyn; Mitchell D Creinin; Kurt T Barnhart; Sharon L Hillier Journal: Obstet Gynecol Date: 2006-01 Impact factor: 7.661
Authors: Ayman Akil; Michael A Parniak; Charlene S Dezzuitti; Bernard J Moncla; Marilyn R Cost; Mingguang Li; Lisa Cencia Rohan Journal: Drug Deliv Transl Res Date: 2011-06-01 Impact factor: 4.617
Authors: Wei Zhang; Minlu Hu; Yuan Shi; Tiantian Gong; Charlene S Dezzutti; Bernard Moncla; Stefan G Sarafianos; Michael A Parniak; Lisa C Rohan Journal: Pharm Res Date: 2015-03-21 Impact factor: 4.200
Authors: Lisa C Rohan; Bernard J Moncla; Ratiya Pamela Kunjara Na Ayudhya; Marilyn Cost; Yunda Huang; Fang Gai; Nicole Billitto; J D Lynam; Kara Pryke; Phillip Graebing; Nicole Hopkins; James F Rooney; David Friend; Charlene S Dezzutti Journal: PLoS One Date: 2010-02-19 Impact factor: 3.240
Authors: Tiantian Gong; Wei Zhang; Michael A Parniak; Phillip W Graebing; Bernard Moncla; Phalguni Gupta; Kerry M Empey; Lisa C Rohan Journal: J Pharm Innov Date: 2017-03-03 Impact factor: 2.750