ABSTRACT
Objectives: The balance of the vaginal ecosystem
depends on lactobacilli whose biofilm protectsagainst microorganisms that are
not normally present or are subdominant in vaginal flora. Vaginal infection treatments should eliminate
pathogens while preserving the Lactobacillus flora to prevent relapse or recurrence. The objective
of this study was to determine the sensitivity of lactobacilli to antiseptics,
antibiotics and antifungal agents used, alone or in combination, in the topical
treatment of infectious vaginitis. Materials and Methods: The minimum
inhibitory concentration (MIC) of 15 active ingredients and the minimum
inhibitory dilution (MID) of 17 pharmaceuticals products were determined for
three main Lactobacillus strains (L.
crispatus, L.
gasseri and L. jensenii).
Results: The MICs of the antibiotics and antifungal agents were above their
critical concentrations in the three strains, contrary to the antiseptics.
According to their MID, some pharmaceutical products, especially combinations,
inhibit the growth of one or more strains at concentrations that can be found
in the vaginal mucosa after application at the usual dosage. Conclusions:
Certain topical anti-infective drugs may interfere with the growth of
lactobacilli, worsening the vaginal flora imbalance. Maintaining vaginal flora
balance should be a selection criterion when choosing an anti-infective therapy.
Cite this paper
Neut, C. , Verrière, F. , Nelis, H. and Coenye, T. (2015) Topical Treatment of Infectious Vaginitis: Effects of Antibiotic, Antifungal and Antiseptic Drugs on the Growth of Normal Vaginal
Lactobacillus Strains.
Open Journal of Obstetrics and Gynecology,
5, 173-180. doi:
10.4236/ojog.2015.53024.
References
[1] Reid, G. (2001) Probiotic Agents to Protect the Urogenital Tract against Infection. The American Journal of Clinical Nutrition, 73, 437S-443S.
[2] Hyman, R.W., Fukushima, M., Diamond, L., Kumm, J., Giudice, L.C. and Davis, R.W. (2005) Microbes on the Human Vaginal Epithelium. Proceedings of the National Academy of Sciences of the United States of America, 102, 7952-7957.
http://dx.doi.org/10.1073/pnas.0503236102
[3] Hay, P. (2005) Life in the Littoral Zone: Lactobacilli Losing the Plot. Sexually Transmitted Infections, 81, 100-102.
http://dx.doi.org/10.1136/sti.2003.007161
[4] Dover, S.E., Aroutcheva, A.A., Faro, S. and Chikindas, M.L. (2008) Natural Antimicrobials and Their Role in Vaginal Health: A Short Review. International Journal of Probiotics and Prebiotics, 3, 219-230.
[5] Boskey, E.R., Telsch, K.M., Whaley, K.J., Moench, T.R. and Cone, R.A. (1999) Acid Production by Vaginal Flora in Vitro Is Consistent with the Rate and Extent of Vaginal Acidification. Infection and Immunity, 67, 5170-5175.
[6] Atassi, F. and Servin, A.L. (2010) Individual and Co-Operative Roles of Lactic Acid and Hydrogen Peroxide in the Killing Activity of Enteric Strain Lactobacillus Johnsonii NCC933 and Vaginal Strain Lactobacillus Gasseri KS120.1 against Enteric, Uropathogenic and Vaginose-Associated Pathogens. FEMS Microbiology Letters, 304, 29-38.
http://dx.doi.org/10.1111/j.1574-6968.2009.01887.x
[7] Eschenbach, D.A., Davick, P.R., Williams, B.L., Klebanoff, S.J., Young-Smith, K., Critchlow, C.M. and Holmes, K.K. (1989) Prevalence of Hydrogen Peroxide-Producing Lactobacillus Species in Normal Women and Women with Bacterial Vaginosis. Journal of Clinical Microbiology, 27, 251-256.
[8] Mijac, V.D., Duki?, S.V., Opavski, N.Z., Duki?, M.K. and Ranin, L.T. (2006) Hydrogen Peroxide Producing Lactobacilli in Women with Vaginal Infections. The European Journal of Obstetrics & Gynecology and Reproductive Biology, 129, 69-76.