Accumulation of penicillin in vaginal fluid

Article Abstract:

When women undergo treatment with antibiotic drugs, they frequently develop vaginitis (vaginal inflammation) as a result of changes in the normal population of vaginal microorganisms (especially lactobacilli). To learn more about the effect of oral penicillin on the vagina, 10 women took phenoxymethylpenicillin (a form of penicillin) either as a single dose or twice a day for 10 days. The concentrations of the drug in blood and vaginal fluid were measured at regular intervals. Results showed that ingestion of one gram of phenoxymethylpenicillin led to a gradual increase in vaginal fluid concentration of the substance during the first three hours, with considerably higher concentrations (of slightly more than one milligram per liter) 15 hours later. Blood and saliva concentrations, however, peaked after one and one-half hours, then declined. Tests under culture conditions revealed that the excreted penicillin was biologically active. Long-term penicillin treatment resulted in high drug concentrations in vaginal fluid (between two and three milligrams per liter). After the subjects stopped their course of medication, levels of phenoxymethylpenicillin were still detectable on day 11, but not on days 12 or 13. This drug is excreted in high concentrations into the vagina, causing a situation that may disturb the balance of microorganisms. The growth of organisms that are resistant to penicillins, or that can produce beta-lactamase (an enzyme that inactivates penicillin), would then be favored. This group includes certain types of rods and yeasts. Other effects of high concentrations of penicillin in the vagina, including those during pregnancy, are described. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Vagina, Penicillin, Penicillins, Vaginitis

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Postoperative urinary tract infection in gynecology: implications for an antibiotic prophylaxis policy

Article Abstract:

Antibiotics are frequently used during surgical procedures to prevent infections, which are frequent complications after surgery. However, prophylactic (preventive) use of antibiotics is not well accepted in association with hysterectomy due to the low frequency of serious infection following this operation. In addition, the benefits of prophylaxis with hysterectomy do not seem to justify the costs and potential risks of antibiotic therapy. However, urinary tract infections are a likely source of postoperative infection, and they are likely to respond to antibiotic prophylaxis. The risk of such infections is increased by urinary catheterization. Urinary tract infection may also occur after hospital discharge, when antibiotics are no longer present in the body. The occurrence of urinary tract infections was evaluated in 115 women who underwent gynecologic surgery. Results revealed that 42 percent of the women who were catheterized for a short period and 32 percent with indwelling catheters developed urinary tract infections. Infections developed in 43 percent of patients who underwent abdominal surgery and 31 percent of those who had vaginal surgery. Only one patient developed a wound infection, and this was the only patient whose discharge was delayed. The results suggest that infection was not related to extensive catheterization. Oral antibiotics specific for bacteria typically found in urinary tract infections may be cost-effective for women undergoing gynecologic surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Antibiotics, Prevention, Risk factors, Surgery, Urinary tract infections, Reproductive organs, Female, Female genitalia, Urinary catheterization, Gynecology, Operative, Gynecological surgery

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Vaginal myxoma presenting as acute urinary retention

Article Abstract:

A vaginal myxoma, an extremely rare tumor, was discovered in a patient suffering from acute urinary retention, an accumulation of urine in the bladder due to an inability to urinate. The tumor had developed rapidly over a four-month period. It was removed, and, during a five-year monitoring period, did not grow back.

Vaginal diseases, Myxoma, Urination disorders

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