HPV Virus Research - Treating

Fiorilli A, Molteni B, Milani M. Obstetric and Gynaecology Departments, "Ospedale Civile di Vimercate, Presidio di Carate", Milan, Italy.

OBJECTIVE:: We evaluated the efficacy of a mucoadhesive vaginal gel (MVG, Miphil(c)) with acidic-buffering properties in bacterial vaginosis (BV). STUDY DESIGN:: Double-blind, placebo-controlled, 12-week trial. SUBJECTS:: A total of 45 non-pregnant women with BV were enrolled in the trial. Patients were treated with MVG 2.5g or the corresponding placebo (P) daily for the first week and then every 3 days for the following 5 weeks (treatment phase) in a 2:1 ratio. All patients were followed for an additional 6 weeks without treatments (follow-up phase). Clinical cure was defined as absence of vaginal discharge, vaginal pH <4.5, a negative fish odour test and a Nugent score <7. RESULTS:: At week 6, 28 out of 30 women (93%) in the MVG group were clinically cured in comparison with only 1 out of 15 (6%) in the P group (P=0.0001). At week 12, 86% of MVG treated women remained cured in comparison with 8% in P group (P=0.0001). At baseline, the vaginal pH was 6.1+/-0.7 in the MVG and 5.5+/-0.7 in the P group. Vaginal pH significantly (P=0.003) decreased to 4.3+/-0.3 in the MVG group. In P group non-significant modifications of vaginal pH were observed (5.1+/-0.5). CONCLUSION:: Our results demonstrated that this MVG is an effective treatment of BV.

Expert Rev Anti Infect Ther. 2004 Dec;2(6):913-22.

Evolving issues in understanding and treating bacterial vaginosis.

Marrazzo JM. University of Washington, Department of Medicine, Harborview Medical Center, Division of Allergy and Infectious Diseases, 325 Ninth Avenue, Mailbox 359931, Seattle, WA 98104, USA.

Bacterial vaginosis is a synergistic polymicrobial syndrome characterized by depletion of Lactobacillus spp., especially those that produce hydrogen peroxide, and an intense increase in the quantity of commensal vaginal anaerobic bacteria to 100- to 1000-fold above normal levels. While the bacterial spectrum of these organisms has long been known to include Gardnerella vaginalis, Prevotella spp., anaerobic Gram-positive cocci, Mobiluncus spp. and Mycoplasma hominis, innovative use of molecular diagnostics has identified novel species apparently associated with this syndrome, including Atopobium vaginalis. Effecting resolution of bacterial vaginosis is important, in particular for the 8 to 23% of women afflicted with symptomatic disease during their reproductive years. Bacterial vaginosis has been consistently associated with numerous adverse sequelae related to the upper genital tract, including pelvic inflammatory disease and postsurgical infection in the setting of invasive gynecologic procedures, and may increase women's risk of acquiring HIV infection. Pregnant women with bacterial vaginosis experience a higher rate of preterm delivery and low-birth-weight infants. While antibiotics with activity against anaerobes--typically, metronidazole and clindamycin applied vaginally or taken orally--are the mainstays of therapy, bacterial vaginosis frequently recurs. For these reasons, innovative approaches to therapy are urgently required.

Publication Types:
• Review
• Review, Tutoria

Chemotherapy. 2005;51 Suppl 1:122-30.

Rifaximin, a peculiar rifamycin derivative: established and potential clinical use outside the gastrointestinal tract.

Pelosini I, Scarpignato C. Laboratory of Clinical Pharmacology, Department of Human Anatomy, Pharmacology and Forensic Sciences, School of Medicine and Dentistry, University of Parma, Parma, Italy.

Rifaximin is a poorly absorbed semisynthetic rifamycin derivative with a broad spectrum of antibacterial activity including Gram-positive and Gram-negative bacteria, both aerobes and anaerobes. Although originally developed for the treatment of infectious diarrhea, the appreciation of the pathogenic role of gut bacteria in several organic and functional gastrointestinal diseases has increasingly broadened its clinical use. The availability of a topical formulation (a cream containing 5% of the drug) and the lack of transcutaneous absorption pointed out in both animal and human studies has allowed its topical use in skin infections. Furthermore, since the spectrum of antibacterial action of rifaximin includes many organisms (e.g. Bacteroides bivius-disiens, Gardnerella vaginalis, Haemophilus ducreyi) causing genital infections, including Trichomonas vaginalis and Chlamydia trachomatis, its local application in the treatment of bacterial vaginosis (BV) has been attempted. Finally, since periodontal disease, caused by plaque (an aggregate of various bacteria), can be considered a 'local' infection, intrapocket rifaximin was tried in the treatment of periodontal infections. While the efficacy in pyogenic infections of the skin has been confirmed by several investigations, which showed an improvement of both subjective and objective parameters significantly better than that of the reference drug (i.e. chlortetracycline or oxytetracycline), the usefulness of rifaximin in BV and periodontal disease needs to be further studied in well-designed clinical trials. Copyright (c) 2005 S. Karger AG, Basel.

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2005 Apr;25(4):362-4.

Clinical observation on treatment of non-gonococcal cervicitis by integrative medicine

HPV Virus Research - Article in Chinese

OBJECTIVE: To explore the integrative medicinal therapy for non-gonococcal cervicitis (NGC) in order to elevate the therapeutic effect for patients treated in vain after long-term application of antibiotics. METHODS: Fifty patients with NGC were treated with Qingyuan decoction combined with antibiotics, and other 46 patients were treated with antibiotics alone for control. RESULTS: The cure rate and significant effective rate was 90.0% (45/50) and 65.2% (30/46) in the treated group and the control group, it was significantly different between the two groups (chi2 = 9.58, P < 0.01). The disappearance rate of symptom was 88.1% and 41.4% in the two group after treated for two weeks respectively, and it was also significantly different (chi2 = 12.42, P < 0.01). CONCLUSIONS: The therapeutic effect of NGC treated by sensitive antibiotics combined with Qingyuan decoction is better than that treated with western medicine only.

HPV Virus Research - Treating HPV and Vaginosis Links

Antibiotics for Treating Bacterial Vaginosis in Pregnancy - Abstract of a systematic review of the effects of health care prepared by the Cochrane Collaboration.

Interventions for Treating Bacterial Vaginosis - Learn about the common treatments for bacterial vaginosis in pregnancy.