K J Agnew1, S L Hillier. 1. Department of Obstetrics and Gynecology, University of Washington, Seattle, USA.
Abstract
BACKGROUND AND OBJECTIVES: The goal of this study was to determine the effect of various treatment regimens on vaginal colonization by H2O2-positive and H2O2-negative lactobacilli. STUDY DESIGN: The subset of women enrolled in a large longitudinal cohort study who had Chlamydia trachomatis (n = 13), bacterial vaginosis (n = 105), yeast vaginitis (n = 15), or mucopurulent cervicitis (n = 47) were compared with 93 women without genital infection from the same population. The effect of various treatment regimens on lactobacilli was evaluated. RESULTS: Use of doxycycline, azithromycin, clotrimazole, and fluconazole had little effect on vaginal colonization by Lactobacillus. Use of oral or vaginal metronidazole led to an increase in Lactobacillus, which persisted 1 month after therapy. Intravaginal clindamycin use caused a decrease 1 week post-therapy, but at 1 month, levels of lactobacilli were similar to those in the metronidazole treatment group. Women treated with oral ampicillin had a modest increase in Lactobacillus levels. CONCLUSIONS: Use of antimicrobial agents for treating vaginitis and cervicitis do not cause a decrease in vaginal colonization by Lactobacillus, which is detectable 1 week to 1 month after treatment.
BACKGROUND AND OBJECTIVES: The goal of this study was to determine the effect of various treatment regimens on vaginal colonization by H2O2-positive and H2O2-negative lactobacilli. STUDY DESIGN: The subset of women enrolled in a large longitudinal cohort study who had Chlamydia trachomatis (n = 13), bacterial vaginosis (n = 105), yeastvaginitis (n = 15), or mucopurulent cervicitis (n = 47) were compared with 93 women without genital infection from the same population. The effect of various treatment regimens on lactobacilli was evaluated. RESULTS: Use of doxycycline, azithromycin, clotrimazole, and fluconazole had little effect on vaginal colonization by Lactobacillus. Use of oral or vaginal metronidazole led to an increase in Lactobacillus, which persisted 1 month after therapy. Intravaginal clindamycin use caused a decrease 1 week post-therapy, but at 1 month, levels of lactobacilli were similar to those in the metronidazole treatment group. Women treated with oral ampicillin had a modest increase in Lactobacillus levels. CONCLUSIONS: Use of antimicrobial agents for treating vaginitis and cervicitis do not cause a decrease in vaginal colonization by Lactobacillus, which is detectable 1 week to 1 month after treatment.
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
Authors: Caroline Mitchell; Lisa E Manhart; Kathy Thomas; Tina Fiedler; David N Fredricks; Jeanne Marrazzo Journal: Infect Dis Obstet Gynecol Date: 2012-05-30