scholarly journals Chlorhexidine, clotrimazole, metronidazole and combination therapy in the treatment of vaginal infections

2021 ◽  
Vol 14 (2) ◽  
pp. 250-256
Author(s):  
Shahla Mirzaeei ◽  
◽  
Maryam Zangeneh ◽  
Firoozeh Veisi ◽  
Somayeh Parsa ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Bacterial Vaginosis ◽  
Vulvovaginal Candidiasis ◽  
Satisfaction Score ◽  
Vaginal Infections ◽  
Vaginal Gel ◽  
Vaginal Cream ◽  
Significant Difference ◽  
The Mean ◽  
Chlorhexidine Gel

This was a clinical trial study that aimed to investigate the efficacy of vaginal chlorhexidine gel in the treatment of vulvovaginal candidiasis, bacterial vaginosis, and nonspecific vaginitis. The study population included patients who complained of vaginal discharge and presented to our University Gynecology Clinic. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software. The student t-test and Mann-Whitney U test were used to analyze the quantitative and ordinal data, respectively. In order to analyze the qualitative data, the Chi-square or Fischer’s exact tests were used. The mean satisfaction score in the vulvovaginal candidiasis patients who received chlorhexiine vaginal gel was 9.06 and 8.29 in the patients who received clotrimazole vaginal cream. The Mann-Whitney test did not show a statistically significant difference between mean scores of VAS in these two groups with vulvovaginal candidiasis (P=0.027). Among the patients with bacterial vaginosis, the mean satisfaction score was 8.91 in the chlorhexidine vaginal gel group and 8.72 in the metronidazole tablet group (P=0.607). In the nonspecific vaginitis group, the mean satisfaction score was 8.83 in the chlorhexidine vaginal gel group and 9.17 in the combination group (metronidazole + clotrimazole vaginal cream)(P=0.401). The highest mean visual analog scale score (VAS) score was documented in the combination therapy group. We found that chlorhexidine vaginal gel is a more effective method for the treatment and improvement of vaginal infections. The benefits of chlorhexidine gel have a positive therapeutic effect as a single drug in nonspecific vaginitis, rather than simultaneous administration of two agents.

scholarly journals BACTERIAL VAGINOSIS;

2017 ◽  
Vol 24 (02) ◽  
pp. 252-257
Author(s):  
Faiqa Saleem ◽  
Munazza Malik ◽  
Muhammad Sohaib Shahid ◽  
Muhammad Tayyab
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Reproductive Age ◽  
P Value ◽  
Vaginal Infections ◽  
Vaginal Gel ◽  
Vaginal Cream ◽  
Significant Difference ◽  
Group A ◽  
Group B

In women of reproductive age bacterial vaginosis is a most common polymicrobialdisease and is the leading reason for vaginal discharge in this age group. Additionally itis further linked with sizeable disease burden of community problem in terms of infectiouscomplications. Clindamycin vaginal cream and metronidazole vaginal gel are effective in themanagement of vaginal infections caused by multi bacteria. Objectives: To compare thetherapeutic efficacy of Metronidazole vaginal gel and clindamycin vaginal cream as modality oftreatment for bacterial vaginosis. Study Design: Randomized control trial. Setting: Departmentof Obstetrics and Gynaecology, Unit-3 Jinnah Hospital Lahore. Period: Six months from 02-05-2011 to 01-11-2011. Material & Methods: A total of 300 patients were included in this study.They were divided into two groups. Group A received metronidazole vaginal gel (5 g dailyfor 7 days) while group B administered with clindamycin vaginal cream (5g daily for 7 days).Results: Mean age of the patient was observed 34.3+3.5 and 32.9+ 2.1 years in group –A andB respectively. Vaginal discharge was absent in 104 patients (69.3%) from group A and 127(84.7%) from group-B. Absence of clue cells on microscopy revealed in 112 patients (74.7%)from group A and 137 patients (91.3%) from group B. Absence of amine odour found in 116patients (77.3%) of group A and 134 patients (89.3%) of group B. Significant difference wasfound between two groups with p value of 0.006 in respect of efficacy. Conclusion: Clindamycinvaginal cream is more effective in comparison to Metronidazole vaginal gel for the treatment ofbacterial vaginosis.

The efficacy and safety of using the topical medicine with combined action in patients with opportunistic vaginal infections

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 22-26
Author(s):  
Vera N. Prilepskaya ◽  
Giuldana R. Bairamova ◽  
Elena A. Mezhevitinova ◽  
Andrei E. Donnikov ◽  
Dmitry Yu. Trofimov ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Genital Tract ◽  
Clinical Signs ◽  
Vulvovaginal Candidiasis ◽  
Long Term Results ◽  
Vaginal Infections ◽  
Aerobic Vaginitis ◽  
Laboratory Parameters ◽  
Recommended Treatment ◽  
Gynecological Examination

Relevance.Infections of the lower genital tract are one of the most common reasons for women to visit a gynecologist. According to various authors, among all vulvovaginitis, the highest percentage of patients visiting a doctor is bacterial vaginosis (2050%), vulvovaginal candidiasis (1739%), trichomoniasis (10%) and other genital infections (10%). In the management of patients with infectious processes of the genitals, the choice of the method of therapy is of great importance, which allows not only to influence the microbes-associates, detected in high concentrations in the womans vagina during the initial episode of the disease, but also to prevent the development of relapses. Aim.To evaluate the clinical and laboratory efficacy, adherence and long-term results of benzydamine use in patients with vulvovaginal candidiasis, aerobic vaginitis and bacterial vaginosis Materials and methods.The study included 31 women aged 18 to 49 years, who complained of abundant discharge from the genital tract, itching, burning, dyspareunia. A comprehensive clinical and laboratory examination was carried out, including the collection of anamnestic data, general and special gynecological examination, microscopy of vaginal smears, KOH test, determination of the pH of the vaginal environment, assessment of vaginal microbiocenosis by quantitative PCR in real time. All patients were prescribed benzydamine hydrochloride, which was used as monotherapy in the form of a vaginal solution according to the recommended treatment regimen specified in the instructions for medical use of the drug TantumRosa 1 (irrigation 2 times a day for 10 days). Results.In 1219 days after beginning treatment, 25 (80.6%) of 31 patients with laboratory signs of vaginal microflora alterations showed restoration of the normal vaginal biocenosis laboratory parameters. Of them, 8 patients initially had dysbiosis, 12 patients yeast-like fungi, 4 patients aerobic vaginitis and 1 patient a combination of dysbiosis and fungi. Herewith, all patients also noted clinical signs of improvement. In 1219 days after beginning treatment, 6 (1.4%) of 31 patients with laboratory signs of vaginal biocenosis alterations had unsatisfactory laboratory parameters; that is vaginal biocenosis alterations (a decrease in Lactobacillus spp. percentage). At the same time, there were no clinical signs of pronounced inflammation such as pathological discharge, hyperemia, vaginal swelling. Conclusion.Benzydamine hydrochloride can be widely used in gynecological practice due to its combined effects on inflammation of the vagina, good clinical and microbiological results. It is important to note that additional therapy with drugs which contain lactobacilli is required only in 19.4% of cases. The clinical and laboratory effectiveness of benzydamine hydrochloride (TantumRosa) was 96.8%, since the relapse rate after 3060 days of the study did not exceed 3.2%.

scholarly journals BACTERIAL VAGINOSIS; COMPARISON BETWEEN METRONIDAZOLE VAGINAL GEL AND CLINDAMYCIN VAGINAL CREAM FOR TREATMENT OF BACTERIAL VAGINOSIS

2017 ◽  
Vol 24 (02) ◽  
pp. 252-257
Author(s):  
Dr. Faiqa Saleem ◽  
Dr. Munazza Malik ◽  
Dr. Muhammad Shahid ◽  
Prof. Muhammad Tayyab
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Gel ◽  
Vaginal Cream

scholarly journals Prevalence of vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis in pregnant women attending antenatal clinic in the middle belt of Ghana

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Dennis Gyasi Konadu ◽  
Alex Owusu-Ofori ◽  
Zuwera Yidana ◽  
Farrid Boadu ◽  
Louisa Fatahiya Iddrisu ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Trichomonas Vaginalis ◽  
Antibiotic Use ◽  
Antenatal Clinic ◽  
Adverse Outcomes ◽  
Vulvovaginal Candidiasis ◽  
Vaginal Infection ◽  
Vaginal Infections ◽  
Cross Sectional

Abstract Background Vaginal infections usually caused by Candida sp, organisms responsible for bacterial vaginosis and Trichomonas vaginalis are associated with considerable discomfort and adverse outcomes during pregnancy and child birth. The study determined the prevalence of vulvovaginal candidiasis (VVC), bacterial vaginosis (BV) and trichomoniasis (TV) in pregnant women attending antenatal clinic at the Kintampo Municipal Hospital. Methods A study adopted a cross sectional design and recruited 589 pregnant women after seeking their informed consent from September, 2014 to March, 2015. Semi-structured questionnaire were administered to participants and vaginal swabs were collected. The samples were analysed using wet mount method and Gram stain (Nugent criteria) for vaginal infection. Univariate and multivariate analysis were used to investigate association of risk factors to vaginal infections. Results The overall prevalence of at least one vaginal infection was 56.4%. The prevalence of vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis were 36.5, 30.9 and 1.4% respectively. Women with more than four previous pregnancies (OR: 0.27, 95% CI: 0.13–0.58) and those in the third trimester of pregnancy (OR: 0.54, CI: 0.30–0.96) were associated with a lower risk of bacterial vaginosis. Douching and antibiotic use were neither associated with VVC or BV. Conclusion The prevalence of vaginal infections was high among pregnant women in the Kintampo area. There is the need for interventions such as adequate investigations and early treatment of vaginal infections to reduce the disease burden to avoid associated complications.

scholarly journals Comparison of intravaginal and oral metronidazole in patients with bacterial vaginosis

2017 ◽  
Vol 6 (10) ◽  
pp. 4213
Author(s):  
Sang Won Han ◽  
Jae Eun Chung
Keyword(s):  
Bacterial Vaginosis ◽  
Group Treatment ◽  
Vaginal Discharge ◽  
Patient Characteristics ◽  
Vulvovaginal Candidiasis ◽  
Study Patient ◽  
Oral Preparation ◽  
The Mean ◽  
Gel Preparation ◽  
Oral Metronidazole

Background: Metronidazole is considered an effective treatment for bacterial vaginosis. Only oral preparations were available until 2014, but an intravaginal gel preparation recently became commercially available in South Korea. In this report, the efficacy and safety of metronidazole intravaginal gel application was compared to that of the conventional oral metronidazole preparation.Methods: Patients who were treated with either intravaginal metronidazole or oral metronidazole after diagnosis of bacterial vaginosis were included in this study. Patient characteristics, mode of treatment, recurrence rate, and complications including gastro-intestinal discomfort and concomitant vulvovaginal candidiasis were analyzed.Results: There were no differences in patient characteristics, except the mean age was older in the intravaginal group. Treatment outcomes were similar in both groups. In the oral metronidazole group, 6.3% of patients reported ongoing symptoms of bacterial vaginosis within one month of treatment and required a refill, while 7.3% of the intravaginal group required a refill. Significantly more patients on oral metronidazole treatment complained about gastro-intestinal discomfort including nausea (13.4%) and diarrhea (9.4%). Patients who took intravaginal metronidazole complained about increased watery vaginal discharge (26.8%). The comparatively high cost of metronidazole intravaginal gel was another factor that could affect patient access to this treatment versus the oral preparation. The incidence of vulvovaginal candidiasis was similar between groups (oral 3.9%, intravaginal 4.9%).Conclusions: Intravaginal metronidazole usage can be considered as an effective alternative treatment for bacterial vaginosis in patients with gastro-intestinal complications. However, the increased incidence of watery vaginal discharge and high cost remain obstacles to widespread use of the intravaginal preparation.

scholarly journals Effect of Combination Therapy of Ceftazidime/Amikacin and Monotherapy with Imipenem on the Treatment of Fever and Neutropenia in Patients with Cancers

2018 ◽  
Vol 6 (8) ◽  
pp. 1423-1430 ◽  
Author(s):  
Ali Arash Anoshirvani ◽  
Nader Zarinfar ◽  
Mohammad Rafiee ◽  
Zahra Zamani
Keyword(s):  
Combination Therapy ◽  
Randomised Trial ◽  
Double Blind ◽  
Patients With Cancer ◽  
Documented Infection ◽  
Microbial Response ◽  
Significant Difference ◽  
The Mean ◽  
Simple Sampling ◽  
Febrile Episodes

AIM: This study aimed to compare the effect of Imipenem monotherapy and combination therapy with Ceftazidime/Amikacin in febrile episodes in neutropenic cancer patients.MATERIALS AND METHODS: In this double-blind randomised trial, 122 adult patients with cancer, neutropenia and fever who were treated by chemotherapy were gathered by simple sampling method and were divided randomly to two equal Imipenem (IP) and Ceftazidime/Amikacin (CA) groups. 500 mg of Imipenem was administered every 6 hours IP group and 2 g of Ceftazidimeplus 15 mg/kg/day in 2 equally divided doses of Amikacin was administered in the CA group. The treatment was continued for 72 hours in both groups. Data were analysed with SPSS19.RESULTS: There was a significant difference between the mean temperatures of three days in each group (P < 0.001). There was no significant difference between the two groups regarding microbial response to antibiotics. There was no significant difference between 19 patients of IP and 13 patients of CA groups regarding bacteriologically documented infection (P = 0.3).CONCLUSION: Unmodified therapy by Imipenem is as effective as combinational therapy by Ceftazidime/Amikacin in clinically and bacteriologically documented infection.

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