Bacterial vaginosis: a primer for clinicians

Reiter, Suzanne; Spadt, Susan Kellogg

doi:10.1080/00325481.2019.1546534

Cited by 51 publications

(63 citation statements)

References 105 publications

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“…Metronidazole and tinidazole belong to the nitroimidazole class of drugs; these are antimicrobial agents used to treat trichomoniasis, amebiasis, and anaerobic bacterial infections. These drugs act by interfering with DNA synthesis [40]. Metronidazole is considered the drug-of-choice for treatment related to bacterial vaginosis; it is a first-generation nitroimidazole, which was initially indicated for the management of trichomoniasis, but was then shown to be effective against anaerobic microorganisms [41].…”

Section: Vaginal Microbiotamentioning

confidence: 99%

“…However, metronidazole therapy is associated with several adverse effects, such as nausea, vomiting, and gastrointestinal complaints [41]. Tinidazole is a second-generation nitroimidazole with a longer half-life than metronidazole (12–14 h vs. 6–7 h) and a better adverse effect profile [40]. The efficacy of tinidazole is similar to that of metronidazole, and a single-dose regimen is at least as effective as clindamycin vaginal cream [40].…”

Section: Vaginal Microbiotamentioning

confidence: 99%

“…Tinidazole is a second-generation nitroimidazole with a longer half-life than metronidazole (12–14 h vs. 6–7 h) and a better adverse effect profile [40]. The efficacy of tinidazole is similar to that of metronidazole, and a single-dose regimen is at least as effective as clindamycin vaginal cream [40]. On the other hand, secnidazole is a novel granular-formulation member of the family of 5-nitroimidazoles that has been approved for the treatment of bacterial vaginosis and trichomoniasis [40].…”

Section: Vaginal Microbiotamentioning

confidence: 99%

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Modifications in Vaginal Microbiota and Their Influence on Drug Release: Challenges and Opportunities

et al. 2019

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Vaginal drug delivery represents an attractive alternative to achieve local and systemic effects due to the high contact surface exposed, the mucoadhesion of the epithelium, and the high innervation that facilitates the absorption of drugs into the bloodstream. However, despite the confinement of the vaginal cavity, it is an organ with a highly variable microenvironment. Mechanical alterations such as coitus, or chemical changes such as pH and viscosity, modify the release of drugs. In addition, changes in vaginal microbiota can influence the entire vaginal microenvironment, thus determining the disposition of drugs in the vaginal cavity and decreasing their therapeutic efficacy. Therefore, the influence of microorganisms on vaginal homeostasis can change the pre-established scenario for the application of drugs. This review aims to provide an explanation of normal vaginal microbiota, the factors that modify it, its involvement in the administration of drugs, and new proposals for the design of novel pharmaceutical dosage forms. Finally, challenges and opportunities directed toward the conception of new effective formulations are discussed.

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Section: Vaginal Microbiotamentioning

confidence: 99%

Section: Vaginal Microbiotamentioning

confidence: 99%

Section: Vaginal Microbiotamentioning

confidence: 99%

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Modifications in Vaginal Microbiota and Their Influence on Drug Release: Challenges and Opportunities

et al. 2019

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“…It is said that 25-60% of preterm births are attributable to maternal infections, and bacterial vaginosis (BV) has been suggested to be a risk factor for preterm birth [15,16]. BV is a condition in which the normal, lactobacillus-predominant vaginal flora is replaced with anaerobic bacteria such as Gardonerella vaginalis and Mycoplasma hominis [17].…”

Section: Discussionmentioning

confidence: 99%

Pregnancies after vaginal radical trachelectomy (RT) in patients with early invasive uterine cervical cancer: results from a single institute

Shinkai

Ishioka

Mariya

et al. 2020

BMC Pregnancy Childbirth

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Background: Radical tracheletomy (RT) with pelvic lymphadenectomy has become an option for young patients with early invasive uterine cervical cancer who desire to maintain their fertility. However, this operative method entails a high risk for the following pregnancy due to its radicality. Methods: We have performed vaginal RT for 71 patients and have experienced 28 pregnancies in 21 patients. They were followed up carefully according to the follow-up methods we reported previously. Their pregnancy courses and prognoses after the pregnancy were retrospectively reviewed. Results: All the vaginal RTs were performed safely without serious complications, including 6 patients who underwent the operation during pregnancy. The median time to be pregnant after RT was 29.5 months. 13 patients (46%) became pregnant without artificial insemination by husband or assisted reproductive technology. Cesarean section was performed for all of them. The median time of pregnancy was 34 weeks, and emergent cesarean section was performed for 7 pregnancies (25%). The median birth weight was 2156 g. Four patients had trouble with cervical cerclage, and they suffered from sudden premature preterm rupture of the membrane (pPROM) during the second trimester of pregnancy. We underwent transabdominal cerclage (TAC) for all of them and careful management for the prevention of uterine infection was performed. One patient had a recurrence of cancer during pregnancy. Conclusions: Both the obstetrical prognosis and oncological prognosis after vaginal RT have become favorable for pregnant patients after vaginal RT.

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“…У беременных данное заболевание встречается в 30-40% случаев, перед родами этот показатель может достигать 45-50%. При этом дрожжеподобные грибы обнаруживаются в небольшом количестве (<10 3 КОЕ/мл) [4, 11,14].…”

Section: Pregnancy and Childbirthunclassified

Treatment of the vaginal disbiotic disorders in pregnant women before delivery

et al. 2019

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The urgency of the problem of vaginal infection is determined by its highest prevalence in the structure of obstetric-gynecological morbidity. Currently, the share of diseases of the lower genital tract associated with quantitative unbalance conditionally pathogenic microorganisms of bacterial and fungal origin vagina, which occur in 40-65% of pregnant women. Carried out a sufficient number of studies showing the role of vaginal microbiocenosis dysbiotic violations in the development of pathology of pregnancy, childbirth and postpartum infectious complications. It is known, that for vaginal infections and dysbiosis significantly more often increases the risk of chronic placental insufficiency, premature birth, low birth weight and postpartum endometritis, wound infection. In connection with the above, it is important to timely diagnose microflora disorders using clinical and laboratory research methods, followed by adequate etiotropic therapy. Timely and effective treatment of vaginal dysbiosis in pregnant women before delivery reduces the risk of postpartum infectious complications.

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Bacterial vaginosis: a primer for clinicians

Cited by 51 publications

References 105 publications

Modifications in Vaginal Microbiota and Their Influence on Drug Release: Challenges and Opportunities

Modifications in Vaginal Microbiota and Their Influence on Drug Release: Challenges and Opportunities

Pregnancies after vaginal radical trachelectomy (RT) in patients with early invasive uterine cervical cancer: results from a single institute

Treatment of the vaginal disbiotic disorders in pregnant women before delivery

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