Biomaterial Database

Microbiologic efficacy of intravaginal clindamycin cream for the treatment of bacterial vaginosis. 1990

S Hillier, and M A Krohn, and D H Watts, and P Wolner-Hanssen, and D Eschenbach

Department of Obstetrics and Gynecology, University of Washington, School of Medicine, Seattle.

Bacterial vaginosis is characterized by replacement of the normal Lactobacillus-predominant vaginal flora with Gardnerella vaginalis, anaerobic bacteria, and Mycoplasma hominis. The present study evaluated the vaginal flora of women with bacterial vaginosis before and after treatment with intravaginal clindamycin cream. Sixty-seven nonpregnant women with symptoms and signs of bacterial vaginosis, and without other genital tract infections, were randomly assigned to receive placebo cream or 0.1, 1, or 2% clindamycin cream. Quantitative vaginal cultures for facultative and anaerobic bacteria and genital mycoplasmas were performed at enrollment and at 4-7 days and 4-5 weeks after completion of therapy. At enrollment, G vaginalis was recovered from 99%, Bacteroides sp from 94%, Peptostreptococcus sp from 81%, and M hominis from 58% of the 67 women with bacterial vaginosis. The vaginal cultures yielded a median of 12 isolates per specimen, with equal numbers of aerobic and anaerobic species. The mean log concentration was 1.2 X 10(9) cfu/mL for aerobic and 2.6 X 10(8) cfu/mL for anaerobic bacteria. After treatment, the frequency and concentration of bacteria per milliliter of vaginal fluid decreased for G vaginalis, Bacteroides sp, Peptostreptococcus sp, and M hominis. The 2% clindamycin cream had the greatest effect on the bacterial vaginosis-associated flora and resulted in clinical resolution of bacterial vaginosis in 15 (94%) of 16 women. Treatment with lower concentrations of clindamycin cream had less effect on the vaginal flora and resulted in clinical cure in 25 (71%) of 35 women. Therapy was associated with an increase in the frequency and concentration of Lactobacillus, and a probably transient increase in the frequency of Escherichia coli and Enterococcus.(ABSTRACT TRUNCATED AT 250 WORDS)

UI	MeSH Term	Description	Entries
D009174	Mycoplasma	A genus of gram-negative, mostly facultatively anaerobic bacteria in the family MYCOPLASMATACEAE. The cells are bounded by a PLASMA MEMBRANE and lack a true CELL WALL. Its organisms are pathogens found on the MUCOUS MEMBRANES of humans, ANIMALS, and BIRDS.	Eperythrozoon,Haemobartonella,Mycoplasma putrefaciens,PPLO,Pleuropneumonia-Like Organisms,Pleuropneumonia Like Organisms
D010462	Peptostreptococcus	A genus of gram-positive, anaerobic, coccoid bacteria that is part of the normal flora of humans. Its organisms are opportunistic pathogens causing bacteremias and soft tissue infections.
D002981	Clindamycin	An antibacterial agent that is a semisynthetic analog of LINCOMYCIN.	7-Chloro-7-deoxylincomycin,Chlolincocin,Chlorlincocin,Cleocin,Clindamycin Hydrochloride,Clindamycin Monohydrochloride,Clindamycin Monohydrochloride, Monohydrate,Dalacin C,7 Chloro 7 deoxylincomycin,Hydrochloride, Clindamycin,Monohydrate Clindamycin Monohydrochloride,Monohydrochloride, Clindamycin,Monohydrochloride, Monohydrate Clindamycin
D005260	Female		Females
D006192	Haemophilus Infections	Infections with bacteria of the genus HAEMOPHILUS.	Hemophilus Infections,Haemophilus influenzae Infection,Haemophilus influenzae Type b Infection,Hib Infection,Infections, Haemophilus,Infections, Hemophilus,Haemophilus Infection,Haemophilus influenzae Infections,Hemophilus Infection,Hib Infections,Infection, Haemophilus,Infection, Haemophilus influenzae,Infection, Hemophilus,Infection, Hib
D006194	Gardnerella vaginalis	A species in the genus GARDNERELLA previously classified as Haemophilus vaginalis. This bacterium, also isolated from the female genital tract of healthy women, is implicated in the cause of bacterial vaginosis (VAGINOSIS, BACTERIAL).	Haemophilus vaginalis,Corynebacterium vaginale,Hemophilus vaginalis
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000282	Administration, Intravaginal	The insertion of drugs into the vagina to treat local infections, neoplasms, or to induce labor. The dosage forms may include medicated pessaries, irrigation fluids, and suppositories.	Administration, Vaginal,Drug Administration, Vaginal,Instillation, Vaginal,Intravaginal Administration,Vaginal Drug Administration,Vaginal Administration,Administration, Vaginal Drug,Administrations, Intravaginal,Administrations, Vaginal,Administrations, Vaginal Drug,Drug Administrations, Vaginal,Instillations, Vaginal,Intravaginal Administrations,Vaginal Administrations,Vaginal Drug Administrations,Vaginal Instillation,Vaginal Instillations
D001439	Bacteroides	A genus of gram-negative, anaerobic, rod-shaped bacteria. Its organisms are normal inhabitants of the oral, respiratory, intestinal, and urogenital cavities of humans, animals, and insects. Some species may be pathogenic.
D014622	Vaginal Creams, Foams, and Jellies	Medicated dosage forms for topical application in the vagina. A cream is a semisolid emulsion containing suspended or dissolved medication; a foam is a dispersion of a gas in a medicated liquid resulting in a light, frothy mass; a jelly is a colloidal semisolid mass of a water soluble medicated material, usually translucent.	Vaginal Creams, Foams and Jellies,Vaginal Cream,Vaginal Creams,Vaginal Foam,Vaginal Foams,Vaginal Gel,Vaginal Jellies,Vaginal Jelly,Vaginal Tablet,Vaginal Tablets,Cream, Vaginal,Creams, Vaginal,Foam, Vaginal,Foams, Vaginal,Gel, Vaginal,Gels, Vaginal,Jellies, Vaginal,Jelly, Vaginal,Tablet, Vaginal,Tablets, Vaginal,Vaginal Gels