Bacterial vaginosis: diagnostic and pathogenetic findings during topical clindamycin therapy

Article Abstract:

Bacterial vaginosis is the inflammation of the vagina resulting from infection with the bacterium Gardnerella vaginalis. The effectiveness of the antibiotic clindamycin (administered into the vagina) in treating bacterial vaginosis was assessed in 67 women with this infection. The sexual practices of these patients were not considered unusual, and nine women had undergone a hysterectomy, the surgical removal of the uterus. The most common symptoms of this infection were an unusual odor and vaginal discharge. In addition, 30 patients complained of irritation of the vagina and surrounding exterior area. The effects of treatment were not correlated with improvement in symptoms. Seven patients had a normal vaginal discharge and were diagnosed with bacterial vaginosis by means other than analysis of discharge. The vaginal pH, a measure of the acidity of the vaginal discharge, was shown to be greater than 4.5, indicating reduced acidity, in almost 60 percent of patients who were successfully treated. The presence of the Mobiluncus species of bacteria was highly specific and not very sensitive in the diagnosis of bacterial vaginosis, whereas the activity of the enzyme proline aminopeptidase in the vaginal fluid was moderately specific and sensitive in diagnosis of this infection. The use of a bacterial identification procedure called Gram staining produced false-positive results in 6.1 percent of tests and frequently yielded inconclusive results from tests done after antibiotic treatment. These results show that recurrence of the infection after antibiotic treatment cannot be predicted by the acidity of the vaginal discharge, gram staining methods, or proline aminopeptidase tests. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Diagnosis, Vagina

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Bacterial vaginosis and prematurity in Indonesia: association in early and late pregnancy

Article Abstract:

Bacterial vaginosis diagnosed at 16 to 20 weeks' gestation was significantly associated with preterm delivery in a study in Indonesia. However, vaginosis diagnosed at 28 to 32 weeks' gestation was not associated with premature delivery. A total of 490 women who had prenatal care in three public hospitals participated in the study. The first evaluation took place when the women were 16 to 20 weeks pregnant. They were tested for bacterial vaginosis then and again when they were 28 to 32 weeks pregnant. Socioeconomic status, smoking, alcohol use and other relevant factors also were assessed. At the first evaluation, 17% of the women tested positive for bacterial vaginosis. Their rate of preterm delivery was 20.2% compared to the 11.8% rate of women without vaginosis.

Complications and side effects, Risk factors, Indonesia

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Intravaginal clindamycin treatment for bacterial vaginosis: effects on preterm delivery and low birth weight

Article Abstract:

Intravaginal application of clindamycin cream to treat bacterial vaginal infection may not be effective in preventing low birth weight or preterm birth associated with infection. Researchers in Indonesia treated 681 pregnant women with bacterial vaginal infections with either clindamycin cream or placebo. While clindamycin cream cured vaginal infections within two weeks of treatment, it did not prevent preterm birth. Clindamycin cream may have eliminated bacterial infection from the vagina but not before the infection spread upwards into the uterus and placenta. Intrauterine infection may trigger preterm labor and delivery. Antibacterial treatments that affect the entire body may successfully eliminate bacterial infection and prevent preterm birth.

Evaluation, Prevention, Vagina, Medication by, Vaginal medication

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