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

Mirzaeei, Shahla; Zangeneh, Maryam; Veisi, Firoozeh; Parsa, Somayeh; hematti, maryam

doi:10.25122/jml-2019-0160

Cited by 7 publications

(5 citation statements)

References 15 publications

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“…Patients treated with chlorhexidine vaginal gel reported high satisfaction scores than those treated with oral metronidazole. The improvement of symptoms was 100% in both groups however, more patients treated with chlorhexidine reported side effects (Mirzaeei et al, 2021 ).…”

Section: Promising Alternative Strategies For Bv Treatmentmentioning

confidence: 99%

“…Antiseptics include a large group of different compounds, such as benzydamine (Boselli et al, 2012 ), chlorhexidine (Mirzaeei et al, 2021 ), dequalinium chloride (Mendling et al, 2016 ), octenidine (Swidsinski et al, 2015 ), polyhexamethylene biguanide (Koban et al, 2012 ), povidone iodine (Wewalka et al, 2002 ), that have been tested against vaginal infections for several years. They have a large spectrum of activity and generally act by the disruption of the cell membrane and very little evidence regarding antimicrobial resistance to these compounds is reported.…”

Section: Promising Alternative Strategies For Bv Treatmentmentioning

confidence: 99%

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Fighting polymicrobial biofilms in bacterial vaginosis

Sousa

Pereira

Cerca

2023

Microbial Biotechnology

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Bacterial vaginosis (BV) is the most common cause of vaginal discharge and is often associated with other health consequences mainly in pregnant women. BV is described by an imbalance in the vaginal microbiota where strictly and facultative anaerobic bacteria outgrow the lactic acid‐ and hydrogen peroxide‐producing Lactobacillus species. The species involved in BV are capable to grow and form a polymicrobial biofilm in the vaginal epithelium. The treatment of BV is usually performed using broad‐spectrum antibiotics, including metronidazole and clindamycin. However, these conventional treatments are associated with high recurrence rates. The BV polymicrobial biofilm may have an important role on the treatment outcome and is accounted as one of the factors for treatment failure. Other possible reasons for treatment failure include the presence of species resistant to antibiotics or the chance of reinfection after treatment. Therefore, novel strategies to increase the rates of treatment have been studied namely the use of probiotics and prebiotics, acidifying agents, antiseptics, plant‐based products, vaginal microbiota transplantation, and phage endolysins. Although some of them are still in an initial phase of development with very preliminary results, they show great perspectives for application. In this review, we aimed to study the role of the polymicrobial nature of BV in treatment failure and explore a few alternatives for treatment.

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Section: Promising Alternative Strategies For Bv Treatmentmentioning

confidence: 99%

Section: Promising Alternative Strategies For Bv Treatmentmentioning

confidence: 99%

Fighting polymicrobial biofilms in bacterial vaginosis

Sousa

Pereira

Cerca

2023

Microbial Biotechnology

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“…Антисептики наиболее эффективны, безопасны, доступны и универсальны для применения при разных причинах патологических выделений из влагалища, за исключением специфических. В течение нескольких лет против вагинальных инфекций тестировались такие соединения, как хлоргексидин [48], деквалиния хлорид [49], октенидин [50], полигексаметиленбигуанид [51], повидон-йод [52]. Они имеют широкий спектр действия и обычно действуют путем разрушения биопленки, при этом пока что имеется мало доказательств антимикробной резистентности к ним.…”

Section: обоснование возможности терапии бактериального вагиноза и ра...unclassified

On the diagnosis and treatment of refractory and recurrent vaginosis and vaginitis in the practice of a gynecologist

Gorbunova,

Apolikhina

2024

Medicinskij sovet

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The relevance of diseases accompanied by pathological secretions from the genital tract is undeniable. This is the leading reason for women to go to a gynecologist. Despite the routine nature of diseases associated with pathological secretions from the genital tract – bacterial vaginosis, aerobic vaginitis, candidiasis vulvovaginitis, mixed vaginitis – the issues of their diagnosis and treatment remain unresolved. In the treatment of vaginosis and vaginitis, we are increasingly faced with the formation of biofilms and, accordingly, a refractory response to treatment or a relapse of the disease. Research shows that refractory response and relapse of the disease are different conditions that require different therapeutic and preventive approaches, but in both cases their cause is often the formation of biofilm. Biofilm vaginitis is a problem of the new century. Biofilms are a difficult task in the treatment of bacterial infections and are one of the main causes of infection persistence. Currently, more than 80% of bacterial infections are caused by the formation of bacterial biofilms. Due to the biofilm, increased tolerance to antimicrobials is maintained for a number of reasons. The article discusses available methods of overcoming antibiotic resistance in bacterial vaginosis and vaginitis, the possibility of avoiding recurrence of the disease without causing significant harm to the vaginal microbiota. Special attention is paid to such an antiseptic as dequalinium chloride. Unlike antibiotics, dequalinium chloride is less toxic to lactobacilli and does not increase the risk of developing candidiasis vulvovaginitis. It works well both on the causes of bacterial vaginosis and on flora unrelated to bacterial vaginosis, which makes it a potentially effective drug for aerobic and mixed vaginitis.

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“…Комплексний засіб з рослинним компонентом Аргіс Дуо®, який чинить широку антисептичну дію, є безпечним, ефективним та зручним у використанні. Основними діючими речовинами препарату є хлоргексидин (активний стосовно грампозитивних й грамнегативних мікроорганізмів, зокрема Gardnerella vaginalis, Сhlamidia spp., Trichomonas spp., Neisseria gonorrhoeae) та витяжка з листя евкаліпту -хлорофіліпт (чинить бактерицидну дію щодо Staphylococcus spp., Streptococcus spp., Candida spp., E.coli, Proteus spp., справляє протизапальний ефект) [3,17].…”

Section: а к у ш е р с т в оunclassified

Modern trends in the treatment of bacterial vaginosis in primigravida in the first half of gestation

Beniuk,

Hychka,

Kovaliuk

et al. 2024

RHW

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Pregnancy with bacterial vaginosis (BV) is accompanied by a high risk of various obstetric and perinatal complications, including miscarriage, preterm birth, placental dysfunction, premature rupture of membranes, chorionamnionitis, polyhydramnios, etc. Screening for BV is carried out in the first half of pregnancy during the registration of a woman, however, taking into account the gestational age, many drugs with antimicrobial and antiseptic effects are categorically contraindicated, as they have an embryo- and fetotoxic effect.Timely detection and correction of microbiocenosis disorders of the birth canal is an extremely important element to prevent a number of obstetric and perinatal complications. A balanced approach in the treatment of vaginal dysbiosis consists in the use of modern combined antiseptic preparations for local treatment, which do not contain antibacterial components and are safe for use during pregnancy.The objective: to determine the effectiveness of the treatment of BV in primigravida women in the first half of pregnancy.Materials and methods. 126 primigravida women aged 18–35 years in the first half of pregnancy were examined during pregnancy registration. The participants were selected randomly.The main group included 36 primigravida women with a gestation period of up to 20 weeks with a diagnosis of BV according to the Amsel and Hay–Ison criteria, who were treated with a combined antiseptic drug (chlorhexidine and chlorophyllipt) – suppository vaginally twice a day, the course of treatment – 5 days. The control group included 30 primigravida women with a gestational age of up to 20 weeks with vaginal normocenosis.For all women the pH of vaginal secretions was determined, followed by microscopy of a native smear, stained according to Gram, and a cultural study was performed. Adherence to the Amsel criteria was also determined, followed by evaluation by the Hay–Ison criteria. The clinical effect was evaluated according to clinical examination data before and on the 6th day of treatment with a combined antiseptic drug (chlorhexidine and chlorophyllipt) using bacterioscopic and bacteriological methods.Results. A normal pH was observed only in every fifth part of examined pregnant woman (28 women – 22.2%), while in the rest patients the acidity of the vaginal environment was not normal. Normocenosis was observed only among 1/3 of primigravida women (37 women – 29.4%). A third of the patients were diagnosed with BV (36 women - 28.6%), every fifth pregnant woman – vulvovaginal candidiasis (28 women - 22.2%).In healthy pregnant women (control group, n=30), the main component of the microbiocenosis was Lactobacillus spp. with a small content of facultatively anaerobic microorganisms. In the main group Atopobium vaginae (38.9%), Gardnerella vaginalis (33.3%), Prevotella bivia (27.8%), Candida spp. (22.2%), as well as Lactobacillus spp. in low titers were dominated. Before the treatment all 36 pregnant women of the main group corresponded to the 3rd type according to the Hay–Ison criteria with the dominance of Gardnerella vaginalis and/or Mobiluncus morphotypes and a small number or complete absence of lactobacilli, which served as the basis for establishing the diagnosis of BV. After treatment type 1 (94.4%) was found in 34 pregnant women, and type 2 (5.6%) – in 2 pregnant women.The results of the microbiological study indicate the normalization of the content of the biotope with the predominance of Lactobacillus spp. in women of the main group, in whom the indicators were similar to the control group.Conclusions. Since pregnancy with BV is accompanied by a high risk of obstetric and perinatal complications, the premorbid background of which is laid already in the first half of pregnancy, there is an urgent need to carry out the birth canal sanitation. The drugs of choice for the BV in the first half of pregnancy are local combined agents of a wide spectrum of action.A universal antiseptic with an anti-inflammatory effect, which includes two components – chlorhexidine and chlorophyllipt, fully meets the recommendations for efficiency and safety and can be used for the BV in the first half of pregnancy.

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

Cited by 7 publications

References 15 publications

Fighting polymicrobial biofilms in bacterial vaginosis

Fighting polymicrobial biofilms in bacterial vaginosis

On the diagnosis and treatment of refractory and recurrent vaginosis and vaginitis in the practice of a gynecologist

Modern trends in the treatment of bacterial vaginosis in primigravida in the first half of gestation

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