The Inhibitory Effect of Clindamycin on <i>Lactobacillus in vitro</i>

Aroutcheva, Alla; Simões, J. A.; Shott, Susan; Faro, Sebastian

doi:10.1155/s1064744901000394

Cited by 23 publications

(17 citation statements)

References 19 publications

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“…7 One limitation of this study is that we did not obtain vaginal swabs for assessment of the vaginal flora after treatment with clindamycin and before administration of lactobacilli. Based on results reported by Aroutcheva et al, 28 clindamycin most likely had the same effect in both study groups, not only eliminating pathogenic microorganisms but also lowering the number of lactobacilli. Therefore, the vaginal flora in the intervention group after antibiotic treatment and before administration of lactobacilli is likely to have been similar to that in the control group.…”

Section: Discussionmentioning

confidence: 57%

The role of Lactobacillus casei rhamnosus Lcr35 in restoring the normal vaginal flora after antibiotic treatment of bacterial vaginosis

Petricevic

Witt

2008

BJOG

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Objective To evaluate the efficacy of additional topical Lactobacillus casei rhamnosus (Lcr35) subsequent to antibiotic treatment of bacterial vaginosis (BV) to restore the normal vaginal flora.Study design Single-centre, randomised, observerblinded study.Setting Population-based study in Vienna over 1 year.Sample 190 women were enrolled in the study.Methods Women with Nugent scores between 7 and 10 on initial vaginal swab were randomised to the one of two groups. All women were treated with standard antibiotic therapy for 7 days. Only women in the intervention group received vaginal capsules containing 10 9 colony-forming units of live Lcr35 for 7 days after antibiotic treatment. Final vaginal swabs for Nugent scoring were taken 4 weeks after the last administration of the study medication.Main outcome measures The primary efficacy variable was a change in the Nugent score between the baseline and the end of the study of at least 5 grades in each individual woman.Results Sixty-nine of the 83 women (83%) in the intervention group and 31 of the 88 women (35%) in the control group showed a reduction of the Nugent score by at least 5 grades. The difference in the number of women with improvement was highly significant (P < 0.001). The median difference in Nugent scores between initial and final swabs was 6.61 in the intervention group and 4.13 in the control group (P < 0.001).Conclusion Our data show that the restoration of the vaginal flora after antibiotic treatment of BV can be significantly enhanced by exogenously applied lactobacilli.

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Section: Discussionmentioning

confidence: 57%

The role of Lactobacillus casei rhamnosus Lcr35 in restoring the normal vaginal flora after antibiotic treatment of bacterial vaginosis

Petricevic

Witt

2008

BJOG

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“…during the week following therapy with metronidazole but not clindamycin is expected, since clindamycin has a broad spectrum of activity against anaerobic as well as aerobic and facultative organisms, like Lactobacillus spp. (2). Metronidazole is a nitroimidazole with activity against obligately anaerobic organisms.…”

Section: Discussionmentioning

confidence: 99%

Microbiologic Response to Treatment of Bacterial Vaginosis with Topical Clindamycin or Metronidazole

et al. 2005

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To compare the frequencies, concentrations, and antimicrobial susceptibilities of vaginal microbes isolated from women with bacterial vaginosis (BV) before and after therapy, 119 nonpregnant women aged 18 to 45 with clinical and Gram stain evidence of BV were randomized to receive intravaginal clindamycin or metronidazole. Vaginal swabs were collected at baseline and 7 to 12 days, 35 to 45 days, and 70 to 90 days following therapy for quantitative vaginal culture. For the 99 women completing all four visits, statistical analyses were performed comparing differences in vaginal microflora between the two treatment arms and between visits in the same treatment group. Antimicrobial susceptibility testing using the agar dilution method was performed for anaerobic gram-negative rods. Although both therapies resulted in decreased colonization by Gardnerella vaginalis and Mycoplasma hominis, only metronidazole treatment resulted in a significant decrease in the frequency and concentration of Prevotella bivia and black-pigmented Prevotella species. Of the 865 anaerobic gram-negative rods evaluated for susceptibility, only 3 (0.3%) were resistant to metronidazole, whereas clindamycin resistance increased significantly for P. bivia and black-pigmented anaerobic gram-negative rods persisting following clindamycin therapy. Clindamycin-resistant subpopulations of P. bivia and black-pigmented Prevotella species emerged 7 to 12 days after therapy even among women colonized initially by clindamycin-susceptible strains. These resistant subpopulations persisted at high frequencies (42 to 50%) 70 to 90 days following therapy. The two topical agents for treatment of BV have differing microbiologic effects on the vaginal microflora. The emergence of clindamycin-resistant anaerobic gram-negative rods following therapy is of concern.

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“…In the present study, we found that the coprisin analogue exerts antibiotic activity against C. difficile but not against the gastrointestinal tract-resident organisms Lactobacillus and Bifidobacterium. Notably, clindamycin has antibiotic activity against both nor-mal microbiota (5) and C. difficile (17); this nonselectivity may be a main cause for antibiotic-associated diarrhea and pseudomembranous colitis in both animals and humans.…”

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confidence: 99%

The Insect Peptide Coprisin Prevents Clostridium difficile-Mediated Acute Inflammation and Mucosal Damage through Selective Antimicrobial Activity

Kang

Hwang

Nam

et al. 2011

Antimicrob Agents Chemother

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Clostridium difficile-associated diarrhea and pseudomembranous colitis are typically treated with vancomycin or metronidazole, but recent increases in relapse incidence and the emergence of drug-resistant strains of C. difficile indicate the need for new antibiotics. We previously isolated coprisin, an antibacterial peptide from Copris tripartitus, a Korean dung beetle, and identified a nine-amino-acid peptide in the ␣-helical region of it (LLCIALRKK) that had antimicrobial activity (J. Here, we examined whether treatment with a coprisin analogue (a disulfide dimer of the nine peptides) prevented inflammation and mucosal damage in a mouse model of acute gut inflammation established by administration of antibiotics followed by C. difficile infection. In this model, coprisin treatment significantly ameliorated body weight decreases, improved the survival rate, and decreased mucosal damage and proinflammatory cytokine production. In contrast, the coprisin analogue had no apparent antibiotic activity against commensal bacteria, including Lactobacillus and Bifidobacterium, which are known to inhibit the colonization of C. difficile. The exposure of C. difficile to the coprisin analogue caused a marked increase in nuclear propidium iodide (PI) staining, indicating membrane damage; the staining levels were similar to those seen with bacteria treated with a positive control for membrane disruption (EDTA). In contrast, coprisin analogue treatment did not trigger increases in the nuclear PI staining of Bifidobacterium thermophilum. This observation suggests that the antibiotic activity of the coprisin analogue may occur through specific membrane disruption of C. difficile. Thus, these results indicate that the coprisin analogue may prove useful as a therapeutic agent for C. difficile infection-associated inflammatory diarrhea and pseudomembranous colitis.-

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The Inhibitory Effect of Clindamycin on Lactobacillus in vitro

Cited by 23 publications

References 19 publications

The role of Lactobacillus casei rhamnosus Lcr35 in restoring the normal vaginal flora after antibiotic treatment of bacterial vaginosis

The role of Lactobacillus casei rhamnosus Lcr35 in restoring the normal vaginal flora after antibiotic treatment of bacterial vaginosis

Microbiologic Response to Treatment of Bacterial Vaginosis with Topical Clindamycin or Metronidazole

The Insect Peptide Coprisin Prevents Clostridium difficile-Mediated Acute Inflammation and Mucosal Damage through Selective Antimicrobial Activity

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